DR. KRISTIN LYNN HICKS MD
Complete NPI Record 1003014549
Psychiatry & Neurology - Psychiatry in Palm Beach Gardens, FL

NPI Status: Active since July 06, 2007

Contact Information

12300 ALTERNATE A1A STE 116
PALM BEACH GARDENS, FL
ZIP 33410
Phone: (772) 349-9304
Fax: (561) 768-4031

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Complete NPI Dataset

The following table represents the complete dataset for NPI number 1003014549. The table includes a list of all field names, values and definitions of the full NPI record. This dataset is available for download in CSV format using the "Download NPI" button below at the end of the table.

Name Value Definition
NPI1003014549The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code1Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Last Name Legal NameHICKSThe last name of the provider. If the provider is an individual, this is the legal name.
Provider First NameKRISTINThe first name of the provider, if the provider is an individual.
Provider Middle NameLYNNThe middle name of the provider, if the provider is an individual.
Provider Name Prefix TextDR.The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential TextMDThe abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address2336 SE OCEAN BLVD STE 145The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City NameSTUARTThe city name in the mailing address of the provider being identified.
Provider Business Mailing Address State NameFLThe State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code349963310The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S USThe country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number7723499304The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number5617684031The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address12300 ALTERNATE A1A STE 116The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NamePALM BEACH GARDENSThe city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameFLThe State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code334102211The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S USThe country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number7723499304The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number5617684031The fax number associated with the location address of the provider being identified.
Provider Enumeration Date7/6/2007The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date3/19/2021The date that a record was last updated or changed.
Provider Gender CodeFThe code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 12084P0800XCode designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1ME113937The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1FLThe code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1Y
Is Sole ProprietorNCode indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
NPI Certification Date3/19/2021