Individual provider Active NPI

Jeanne K Hickman, GNP

  • Gerontology Nurse Practitioner
  • Battle Creek, MI
National Provider Identifier
1962410407
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
JH064997 Issued in MI
Practice address
632 North Ave
Battle Creek, MI 49017-3249
Phone
(269) 969-6145
Fax
(269) 969-6133
NPI assigned
Aug 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X JH064997 MI Primary

Addresses

Primary practice location

632 North Ave
Battle Creek, MI 49017-3249

Mailing address

632 North Avenue
Battle Creek, MI 49017
Phone (269) 969-6145

Other identifiers 1

IdentifierTypeStateIssuer
JH064997OtherMILICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
JH064997MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Pointe Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962410407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 NORTH AVENUE",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "49017",
            "telephone_number": "269-969-6145",
            "fax_number": "269-969-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 NORTH AVE",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490173249",
            "telephone_number": "269-969-6145",
            "fax_number": "269-969-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKMAN",
        "first_name": "JEANNE",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "JH064997",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "JH064997",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.