NPIMap

Individual provider Active NPI

Abigail B Kick, CRNP

  • Adult Health Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1982042826
Registry record updated Nov 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R256711 Issued in MD
Practice address
11110 Medical Campus Rd Ste 130
Hagerstown, MD 21742-6799
Phone
(301) 665-4710
NPI assigned
Jun 13, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X SP013006 PA
Adult Health Nurse Practitioner 363LA2200X R256711 MD Primary

Addresses

Primary practice location

11110 Medical Campus Rd Ste 130
Hagerstown, MD 21742-6799

Mailing address

11110 Medical Campus Rd Ste 130
Hagerstown, MD 21742-6799
Phone (301) 665-4710

Other identifiers 1

IdentifierTypeStateIssuer
102860739MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221220002729 MD Practitioner - Nurse Practitioner 1355575978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11110 Medical Campus Rd
Suite 130
Hagerstown, MD 21742-6799
Phone (301) 665-4710

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R256711MDMDAdult Health Nurse Practitioner
SP013006PAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Practices of Antietam LLC CurrentSince Nov 10, 2022 Accepting new patients
Medical Practices of Antietam, LLC CurrentSince Nov 10, 2022 Accepting new patients
Meritus Medical Laboratory LLC Past Accepting new patients

Locations

11110 Medical Campus Rd
Ste 130
Hagerstown, MD 21742
Phone (301) 665-4710

13620 Crayton Blvd
Hagerstown, MD 21742
Phone (240) 313-3100

11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600

3 Byrkit Dr
Williamsport, MD 21795
Phone (301) 582-1150

Organizations & group practices 3

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669075200000",
    "number": "1982042826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 130",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426799",
            "telephone_number": "301-665-4710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 130",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426799",
            "telephone_number": "301-665-4710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICK",
        "first_name": "ABIGAIL",
        "middle_name": "B",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-13",
        "last_updated": "2022-11-22",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "PA",
            "license": "SP013006",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R256711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102860739",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.