DR. OTRIE BERTRELLE HICKERSON (NPI# 1578739934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1578739934 |
Entity Type | Individual |
Full Name | DR. OTRIE BERTRELLE HICKERSON |
Other Name | DR. OTRIE B HICKERSON-SMITH |
Credential | M. D. |
Practice Address |
1134 Winter St Jackson MS 39204-2841 |
Practice Telephone | 6019485572 |
Practice Fax Number | 6013537070 |
Mailing Telephone | 6019485572 |
Mailing Fax Number | 6013537070 |
Enumeration Date | 2008-05-06 |
Last Update Date | 2008-05-06 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 172V00000X | Community Health Worker | 05738 | MS | Other Service Providers |
Street Address |
1134 WINTER ST |
City | JACKSON |
State | MS |
Zip Code | 39204-2841 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144281262 | Michael Reese Johnson | Family Medicine | 1134 Winter St, Jackson, MS 39204-2841 | 2006-03-29 |
1215560545 | Chinnika Latrice Crisler | Social Worker | 1134 Winter St, Jackson, MS 39204-2841 | 2020-02-14 |
1912471939 | Zipora Martin-brown | Nurse Practitioner | 1134 Winter St, Jackson, MS 39204-2841 | 2019-01-12 |
1538697453 | Trevalla Kaye Lindsey | Nurse Practitioner | 1134 Winter St, Jackson, MS 39204-2841 | 2017-05-23 |
1073069498 | Central Mississippi Health Services, Inc. | Preferred Provider Organization | 1134 Winter St, Jackson, MS 39204-2841 | 2016-08-26 |
1982001632 | Catina Shavon Butler | Nurse Practitioner | 1134 Winter St, Jackson, MS 39204-2841 | 2014-11-24 |
1376948075 | Shaquita Shaw | Nurse Practitioner | 1134 Winter St, Jackson, MS 39204-2841 | 2014-10-24 |
1427458819 | Latoya P. Johnson | Physician Assistant | 1134 Winter St, Jackson, MS 39204-2841 | 2014-09-04 |
1568598027 | Ericka M Micou | Nurse Practitioner | 1134 Winter St, Jackson, MS 39204-2841 | 2007-02-26 |
1851321384 | Obie M. Mcnair | Internal Medicine | 1134 Winter St, Jackson, MS 39204-2841 | 2006-07-03 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639797442 | Walk By Faith Not By Sight Homecare | Student in an Organized Health Care Education/Training Program | 2310 Us-80 West, Suite F 1154, Jackson, MS 39204 | 2020-07-08 |
1427593888 | Care First Home Care Agency, Inc | In Home Supportive Care | 931 Hwy 80 Suite 2 B-9, Jackson, MS 39204 | 2016-12-21 |
1134678808 | Yolonda Kinzie | Registered Nurse | 1134 Winter St., Jackson, MS 39204 | 2016-09-23 |
1578983938 | Seaneather Arline Mcgill | Nurse's Aide | 2024 Shady Lane Dr, Jackson, MS 39204 | 2014-04-23 |
1942591128 | Real Solutilons, LLC | Exclusive Provider Organization | 831 Hwy 80 W., Jackson, MS 39204 | 2011-04-22 |
1548405236 | Visions Physical Therapy | Specialist/Technologist | 4700 Robinson Rd, Jackson, MS 39204 | 2008-12-09 |
1588759393 | Donald H Butts | Specialist | 1920 Chadwick Drive, Suite 109, Jackson, MS 39204 | 2006-10-04 |
1003907460 | Patrick E Weldon | Psychiatry & Neurology | 1860 Chadwick Drive, Suite 258, Jackson, MS 39204 | 2006-09-28 |
1922117662 | Elgin Kenneth Walley | Dentist | 2174 Henry Hill Drive, Jackson, MS 39204 | 2006-08-29 |
1376555045 | Linda Nell Hunter | Nurse Practitioner | 1860 Chadwick Dr Ste 150a, Jackson, MS 39204 | 2006-08-12 |
Find all providers in zip 39204 |
Taxonomy Code | 172V00000X |
Grouping | Other Service Providers |
Classification | Community Health Worker |
Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care system in both urban and rural environments and usually share ethnicity, language, socioeconomic status and life experiences with the community members they serve. They have been identified by many titles such as community health advisors, lay health advocates, "promotores(as), outreach educators, community health representatives, peer health promoters, and peer health educators. CHWs offer interpretation and translation services, provide culturally appropriate health education and information, assist people in receiving the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening. Some examples of these practitioners are Community Health Aides or Practitioners established under 25 USC §1616 (l) under HHS, Indian Health Service, Public Health Service. |
Notes: Source: Health Resources and Services Administration, US Department of Health and Human Services – National Workforce Study on Community Health Workers, March, 2007. [7/1/2007: new] http://bhpr.hrsa.gov/healthworkforce/chw/ |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679111389 | Tawny Renee Williams | Community Health Worker | 409 Briarwood Dr Ste 302, Jackson, MS 39206-3033 | 2019-12-12 |
1811343684 | Eugene Morgan | Community Health Worker | 5773 Old Canton Rd, Jackson, MS 39211-3202 | 2016-05-10 |
1588022727 | Front Page Fame LLC | Community Health Worker | 115 Directors Row, Jackson, TN 38305-2316 | 2016-02-02 |
1548625106 | Beth Wingart | Community Health Worker | 1703 Chapin St, Jackson, MI 49203-2000 | 2015-12-28 |
1205205564 | Michelle Perusse | Community Health Worker | 501 Seymour Ave, Jackson, MI 49202-3564 | 2015-09-16 |
1639569742 | Thomas White | Community Health Worker | 2370 N High St, Suite Number 5, Jackson, MO 63755-8365 | 2015-01-27 |
1316368343 | Mcnair Chronic Disease Consultant | Community Health Worker | 5120 Galaxie Dr Ste B, Jackson, MS 39206-4308 | 2013-12-17 |
1700023983 | Carli Lyon | Community Health Worker | 3021 Rangeview Dr, Jackson, WY 83002-3021 | 2009-01-09 |
1225287139 | Ralph Wendell Mims | Community Health Worker | 3708 Kennebrew Road, Jackson, MS 39209 | 2008-09-16 |
1790331643 | Eps On The Go II | Community Health Worker | 5773 Old Canton Rd, Jackson, MS 39211-3202 | 2019-08-16 |
Find all providers in JACKSON |
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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.