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PATHWAY TO WELLNESS HEALTHCARE CENTER
NPI 1265040380
Nurse Practitioner - Family in Baltimore, MD

Active since July 14, 2020
4200 EDMONDSON AVE STE 205, BALTIMORE, MD 21229(443) 739-3814(240) 348-2962 Get Directions Write a Review

NPPES record last updated: April 22, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 22, 2026, Oct 10, 2025, Apr 19, 2024 and 5 more (8 updates tracked since 2020).

About Pathway To Wellness Healthcare Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PATHWAY TO WELLNESS HEALTHCARE CENTER (NPI 1265040380) is a healthcare organization registered as a family in Baltimore, Maryland and active in the NPI registry since July 2020. The organization maintains a secondary practice location in Baltimore and lists Nicole Denise Hickson, Family Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1265040380
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NamePATHWAY TO WELLNESS HEALTHCARE CENTER
Location Address4200 EDMONDSON AVE STE 205Baltimore, MD 21229-1614
Mailing Address1120 N Charles St Ste 400Baltimore, MD 21201-5594 · (443) 739-3814 · Fax (833) 975-0904
Phone(443) 739-3814
Fax(240) 348-2962
Organization SubpartNo
Authorized OfficialNicole Denise HicksonFamily Nurse Practitioner · (443) 739-3814
Enumeration DateJuly 14, 2020
Last NPPES UpdateApril 22, 20268 updates tracked since enumeration
NPPES CertifiedApril 22, 2026
✔ NPI 1265040380 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
4200 EDMONDSON AVE STE 205, Baltimore, MD 21229
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Secondary Practice Location 1

Location 11120 N Charles St Ste 400Baltimore, MD 21201-5594 · Phone (443) 739-3814 · Fax (833) 975-0904

Other Identifiers 1

Medicaid666351600MD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REFRESH PAIN AND WELLNESS, LLC
Clinic/Center (Mental Health (Including Community Mental Health Center))
4200 EDMONDSON AVE STE 205
BALTIMORE, MD 21229
Baltimore City (443) 893-3808

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pathway To Wellness Healthcare Center's NPI number?

The NPI number for Pathway To Wellness Healthcare Center is 1265040380. It was assigned to this organization in the NPPES registry on July 14, 2020.

Where is Pathway To Wellness Healthcare Center located?

Pathway To Wellness Healthcare Center is located at 4200 Edmondson Ave Ste 205, Baltimore, MD 21229. The listed phone number is (443) 739-3814.

What is Pathway To Wellness Healthcare Center's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Pathway To Wellness Healthcare Center was last updated on April 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.