Active NPI
Anna Maria Hickok, LPN
- Licensed Practical Nurse
- Carthage, NY
National Provider Identifier
1003948001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 277484-1
- Practice address
- 258 Champion St
Building 500
Carthage, NY 13619-3361 - Phone
- (315) 408-2869
- NPI assigned
- Mar 12, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 277484-1 | NY | Primary |
Addresses
Primary practice location
258 Champion St
Building 500
Carthage, NY 13619-3361
Mailing address
4814 Texas Rd
Carthage, NY 13619-6056
Phone (315) 493-0558
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277484-1 | NY | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003948001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4814 TEXAS RD",
"city": "CARTHAGE",
"state": "NY",
"postal_code": "136196056",
"telephone_number": "315-493-0558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "258 CHAMPION ST",
"address_2": "BUILDING 500",
"city": "CARTHAGE",
"state": "NY",
"postal_code": "136193361",
"telephone_number": "315-408-2869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKOK",
"first_name": "ANNA",
"middle_name": "MARIA",
"name_prefix": "Mrs.",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "NY",
"license": "277484-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Carthage, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.