Angie D Hicks-master, ANP - Medicare Nurse Practitioner in Manila, AR

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Angie D Hicks-master, ANP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Manila, Arkansas. She graduated from nursing school in 2005 and has 19 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Foundation A Wellness Practice, Llc, Delta Behavioral Health, Llc and her current practice location is 920 East Medical Drive, Manila, Arkansas. You can reach out to her office (for appointments etc.) via phone at (810) 570-0358.

Angie D Hicks-master is licensed to practice in Tennessee (license number APN0000017515) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1255405353.

Contact Information

Angie D Hicks-master, ANP
920 East Medical Drive,
Manila, AR 72442
(810) 570-0358
(870) 570-0359

Map and Direction




Provider's Profile

Full NameAngie D Hicks-master
GenderFemale
SpecialityNurse Practitioner
Experience19 Years
Location920 East Medical Drive, Manila, Arkansas
Accepts Medicare AssignmentsMay be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Angie D Hicks-master graduated from nursing school in 2005
  NPI Data:
  • NPI Number: 1255405353
  • Provider Enumeration Date: 11/20/2006
  • Last Update Date: 05/28/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 5496858110
  • Enrollment ID: I20070316000197

Medical Identifiers

Medical identifiers for Angie D Hicks-master such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255405353NPI-NPPES
2007012778OtherMOMO STATE LICENSE
A002923OtherARAR STATE LICENSE
17515OtherTNTN STATE LICENSE

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0808XNurse Practitioner - Psychiatric/mental Health A002923 (Arkansas)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health APN0000017515 (Tennessee)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
St Bernards Medical CenterJonesboro, ARHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Foundation A Wellness Practice, Llc26687181724
Delta Behavioral Health, Llc64062800076

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Angie D Hicks-master allows following entities to bill medicare on her behalf.
Entity NameJim Pang
Entity TypePractitioner - Psychiatry
Entity IdentifiersNPI Number: 1780690230
PECOS PAC ID: 2769459338
Enrollment ID: I20070113000145
Entity NameNortheast Arkansas Community Mental Health Center Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1336118207
PECOS PAC ID: 0244130839
Enrollment ID: O20040110000206
Entity NameFoundation: A Wellness Practice, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750878203
PECOS PAC ID: 2668718172
Enrollment ID: O20190103002743
Entity NameDelta Behavioral Health, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1720637085
PECOS PAC ID: 6406280007
Enrollment ID: O20200107000093
Entity NameA Time For Peace Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1912392549
PECOS PAC ID: 1850627415
Enrollment ID: O20200901000136

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Angie D Hicks-master is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Angie D Hicks-master, ANP
P.o. Box 717,
Manila, AR 72442

Ph: (870) 570-0358		Angie D Hicks-master, ANP
920 East Medical Drive,
Manila, AR 72442

Ph: (810) 570-0358

Reviews and Comments


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Morgan Bliss Noble, APRN
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Allison Nicole Hitt, ARPN
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Phone: 870-974-1110    
Danna Scott Deaton, APRN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 3644 W St Hwy 18, Suite B, Manila, AR 72442
Phone: 870-561-3300    Fax: 870-561-3307

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.