Individual provider Active NPI

Beth Hicks, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1962893776
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN11017578 Issued in FL
Practice address
379 6TH Ave W
Bradenton, FL 34205-8820
Phone
(941) 782-4150
Fax
(941) 782-4104
NPI assigned
Feb 16, 2015
Last updated
May 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704182411 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN11017578 FL Primary

Addresses

Primary practice location

379 6TH Ave W
Bradenton, FL 34205-8820

Mailing address

PO Box 197515
Nashville, TN 37219-7515
Phone (941) 782-4391

Other practice location 1

6777 W Maple Rd
West Bloomfield, MI 48322-3013
Phone (248) 325-3353

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bhicks17556@direct.hfhs.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150514001272 MI Practitioner - Nurse Practitioner 8628398625 Reassigns benefits to 2 organizations
I20221118000183 FL Practitioner - Nurse Practitioner 8628398625 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Centerstone of Florida IncGroup PAC ID 2668468596, 35 clinicians

Practice addresses (Care Compare)

379 6TH Ave W
Bradenton, FL 34205-8820
Phone (941) 782-4150

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centerstone of Florida, Inc. CurrentSince May 8, 2022 Accepting new patients
Henry Ford Health System Family CurrentSince Apr 8, 2015 Accepting new patients
Centerstone of Florida, Inc. CurrentSince Aug 11, 2022 Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Jan 1, 2021 Accepting new patients
Henry Ford Wyandotte Hospital CurrentSince Jan 1, 2021 Accepting new patients
Henry Ford Health System CurrentSince Apr 8, 2015 Accepting new patients

Locations

2020 26th Ave E
Bradenton, FL 34208
Phone (941) 782-4600

379 6th Ave W
Bradenton, FL 34205
Phone (941) 782-4100

1 Ford Pl
#2E
Detroit, MI 48202
Phone (313) 874-4688

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

6777 W Maple Rd
West Bloomfield, MI 48322
Phone (248) 325-1000

2070 Biddle Ave
Ste 2
Wyandotte, MI 48192
Phone (734) 284-7482

2333 Biddle Ave
Wyandotte, MI 48192
Phone (734) 246-6000

Interoperability endpoints

  • Direct secure messaging: bhicks17556@direct.hfhs.org

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1962893776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 197515",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372197515",
            "telephone_number": "941-782-4391",
            "fax_number": "941-782-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "379 6TH AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058820",
            "telephone_number": "941-782-4150",
            "fax_number": "941-782-4104"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6777 W Maple Rd",
            "address_purpose": "LOCATION",
            "city": "West Bloomfield",
            "state": "MI",
            "postal_code": "483223013",
            "country_code": "US",
            "telephone_number": "248-325-3353",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "BETH",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-16",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704182411",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11017578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bhicks17556@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "6777 W Maple Rd",
            "city": "West Bloomfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "483223013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.