Individual provider Active NPI

Brandy Johnson Hicks, NP

  • Nurse Practitioner
  • Hickory, NC
National Provider Identifier
1003640277
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F09241197 Issued in NC
Practice address
18 13TH Ave NE
Hickory, NC 28601-3748
Phone
(828) 322-2644
NPI assigned
Aug 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NC
Nurse Practitioner 363L00000X F09241197 NC Primary

Addresses

Primary practice location

18 13TH Ave NE
Hickory, NC 28601-3748

Mailing address

18 13TH Ave NE
Hickory, NC 28601-3748
Phone (828) 322-2644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250218003761 NC Practitioner - Nurse Practitioner 5890215016 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Catawba Radiological Associates IncGroup PAC ID 9335036789, 17 clinicians

Practice addresses (Care Compare)

18 Thirteenth Ave NE
Hickory, NC 28601-3748
Phone (828) 322-2644

Hospital & facility affiliations

  • Catawba Valley Medical Center Hospital, Hickory, NC, CCN 340143
  • Frye Regional Medical Center Hospital, Hickory, NC, CCN 340116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F09241197NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Catawba Radiological Associates, Inc. CurrentSince Nov 30, 2024 Accepting new patients

Locations

18 13th Ave NE
Hickory, NC 28601
Phone (828) 322-2644

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1003640277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 13TH AVE NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013748",
            "telephone_number": "828-322-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 13TH AVE NE",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013748",
            "telephone_number": "828-322-2644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "BRANDY",
        "middle_name": "JOHNSON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "F09241197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

Verify at the official NPI Registry.