DR. JONATHON BLAKE HICKS (NPI# 1215535919) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215535919 |
| Entity Type | Individual |
| Full Name | DR. JONATHON BLAKE HICKS |
| Credential | DNP, APRN, PMHNP |
| Practice Address |
1530 Lone Oak Rd Ste 345 Paducah KY 42003-7901 |
| Mailing Address |
2200 Jefferson Ave Fl 5 Toledo OH 43604-7102 |
| Practice Telephone | 2704442250 |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2020-11-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
3015209 | KY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1530 LONE OAK RD STE 345 |
| City | PADUCAH |
| State | KY |
| Zip Code | 42003-7901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801429428 | Amanda Raether | Social Worker | 1530 Lone Oak Rd Ste 345, Paducah, KY 42003-7901 | 2020-02-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033757638 | Wilson Medical Staffing Pllc | Nurse Practitioner | 3130 Lone Oak Rd, Paducah, KY 42003 | 2019-12-13 |
| 1417415993 | Lauren Deanne Mcclain | Nurse Practitioner | 225 Medical Center Dr Ste 205, Paducah, KY 42003 | 2019-03-04 |
| 1871057042 | Brame Psychological Assessment Center | Psychologist | Ray and Kay Eckstein Outreach Center, 435 Berger Rd, Paducah, KY 42003 | 2019-01-22 |
| 1831611219 | Elizabeth Anne Wright | Social Worker | 425 Broadway Street, Paducah, KY 42003 | 2017-07-07 |
| 1558804724 | Kayla Reshea Franklin | Behavior Technician | 2075 Husband Road, Paducah, KY 42003 | 2016-11-21 |
| 1699189308 | Sunrise Children's Services, Inc. | Foster Care Agency | 3565 Lone Oak Rd Ste 2, Paducah, KY 42003 | 2014-06-20 |
| 1326488891 | Alice Ann Higdon Wilham | Surgery | 1532 Lone Oak Rd Ste 235, Paducah, KY 42003 | 2013-06-28 |
| 1881924611 | Meghan Ashley Lee | Nurse Practitioner | 1532 Lone Oak Rd Ste 245, Paducah, KY 42003 | 2009-12-29 |
| 1174771018 | Sleep Source Kentucky, LLC | Clinic/Center | 3125 Parisa Drive, Paducah, KY 42003 | 2008-09-04 |
| 1851547426 | Zandra Bristol Farley | Registered Nurse | 1532 Lone Oak Road Suite 445, Lourdes Marshall Nemer Pavillion, Paducah, KY 42003 | 2008-08-14 |
| Find all providers in zip 42003 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073076071 | Devin Michael Lewis | Nurse Practitioner | 425 Broadway St, Paducah, KY 42001-0713 | 2019-04-08 |
| 1003390980 | Phyllis Vance | Nurse Practitioner | 1530 Lone Oak Rd, Paducah, KY 42003-7901 | 2018-09-18 |
| 1780196121 | Katharine Dawson Coale | Nurse Practitioner | 1530 Lone Oak Rd, Paducah, KY 42003-7901 | 2017-10-25 |
| 1396154480 | Fumiko Hattori | Nurse Practitioner | 425 Broadway St, Paducah, KY 42001-0713 | 2014-08-04 |
| 1497705073 | Janet Ambler | Nurse Practitioner | 1532 Lone Oak Rd, Suite 345, Paducah, KY 42003-7942 | 2006-05-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720634 | Lauren Ann Thacker | Nurse Practitioner | 648 Stonehenge Drive, Pikeville, KY 41501 | 2020-11-03 |
| 1861099269 | Bowling Green Psychiatry | Nurse Practitioner | 1911 Scottsville Rd Ste B, Bowling Green, KY 42104-3303 | 2020-10-08 |
| 1811594385 | Christine Young | Nurse Practitioner | 6804 Bainbridge Ct, Louisville, KY 40228-2335 | 2020-10-07 |
| 1578170890 | Rebecca O'hair | Nurse Practitioner | 500 Thames Cir, Nicholasville, KY 40356-9219 | 2020-09-30 |
| 1255948154 | Kathleen B Berghausen | Nurse Practitioner | 4112 Fern Valley Rod, Louisville, KY 40219 | 2020-09-25 |
| 1235749581 | Melissa K Young-flynn | Nurse Practitioner | 713 Millpond Rd, Lexington, KY 40514-1570 | 2020-08-02 |
| 1285243477 | Stephanie Atherton | Nurse Practitioner | 1623 Story Ave, Louisville, KY 40206 | 2020-07-24 |
| 1649889932 | Hannah Rose Wilson Gibbs | Nurse Practitioner | 326 Roland Avenue, Owenton, KY 40359 | 2020-07-23 |
| 1962020875 | Sheryl List | Nurse Practitioner | 2103 Madison Dr, Hebron, KY 41048-7399 | 2020-07-07 |
| 1619594751 | Whitney Mariah Rizzo | Nurse Practitioner | 2774 Petros Browning Rd, Rockfield, KY 42274-9762 | 2020-07-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.