Individual provider Active NPI

Tasha Michelle Hicks, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Ocoee, FL
National Provider Identifier
1972055218
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN9298689 Issued in FL
Practice address
11140 W Colonial Dr Ste 1
Ocoee, FL 34761-3300
Phone
(407) 877-6500
Fax
(321) 203-4612
NPI assigned
Nov 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN9298689 FL Primary

Addresses

Primary practice location

11140 W Colonial Dr Ste 1
Ocoee, FL 34761-3300

Mailing address

11140 W Colonial Dr Ste 1
Ocoee, FL 34761-3300
Phone (407) 877-6500

Other practice location 1

525 Technology Park Ste 109
Lake Mary, FL 32746-7107
Phone (407) 647-2346

Other identifiers 1

IdentifierTypeStateIssuer
021603000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190828003640 FL Practitioner - Nurse Practitioner 2567790512 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Dr Luisa Vega DNP LLCGroup PAC ID 3577872605, 83 clinicians

Practice addresses (Care Compare)

1044 E Brandon Blvd
Suite 1And2
Brandon, FL 33511-5509
Phone (813) 403-4423

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN9298689FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Orlando Health, Inc. Current Accepting new patients
Dr Luisa Vega DNP LLC Psychiatric/Mental Health CurrentSince Jun 1, 2023 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 5, 2019 Accepting new patients
Orlando Health Medical Group Inc CurrentSince Aug 5, 2019 Accepting new patients
Orlando Physicians Network Inc CurrentSince Aug 11, 2021 Accepting new patients

Locations

1044 E Brandon Blvd
Ste 12
Brandon, FL 33511
Phone (813) 403-4423

525 Technology Park
Lake Mary, FL 32746
Phone (407) 347-4331

525 Technology Park
Ste 109
Lake Mary, FL 32746
Phone 4076472346 ext. 111

11140 W Colonial Dr
Ste 1
Ocoee, FL 34761
Phone (407) 877-2111

10000 W Colonial Dr
Ocoee, FL 34761
Phone (321) 843-1378

32 W Gore St
Orlando, FL 32806
Phone (321) 841-3820

1414 Kuhl Ave
#38
Orlando, FL 32806
Phone (407) 481-7179

21 Columbia St
Orlando, FL 32806
Phone (321) 841-5560

Interoperability endpoints

  • Direct secure messaging: thicks28067@orlandohealth.medalliesdirect.net

Organizations & group practices 5

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": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733443200000",
    "number": "1972055218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11140 W COLONIAL DR STE 1",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613300",
            "telephone_number": "407-877-6500",
            "fax_number": "321-203-4612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11140 W COLONIAL DR STE 1",
            "city": "OCOEE",
            "state": "FL",
            "postal_code": "347613300",
            "telephone_number": "407-877-6500",
            "fax_number": "321-203-4612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "525 Technology Park Ste 109",
            "address_purpose": "LOCATION",
            "city": "Lake Mary",
            "state": "FL",
            "postal_code": "327467107",
            "country_code": "US",
            "telephone_number": "407-647-2346",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "TASHA",
        "middle_name": "MICHELLE",
        "name_prefix": "Ms.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-03",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9298689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021603000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocoee, FL

Sources for this page

Verify at the official NPI Registry.