Individual provider Active NPI

James Stacy Hicks, M.D.

  • Family Medicine Physician
  • Knoxville, TN
National Provider Identifier
1023061397
Registry record updated Apr 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25397 Issued in TN
Practice address
1300 Old Weisgarber Rd
Knoxville, TN 37909-1291
Phone
(865) 584-2146
Fax
(865) 584-9660
NPI assigned
May 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25397 TN Primary

Addresses

Primary practice location

1300 Old Weisgarber Rd
Knoxville, TN 37909-1291

Mailing address

1300 Old Weisgarber Rd
Knoxville, TN 37909-1291
Phone (865) 584-2146

Other identifiers 1

IdentifierTypeStateIssuer
3081789MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Hicks.James@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040818000485 TN Practitioner - Family Practice 6608849559 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

1300 Old Weisgarber Rd
Knoxville, TN 37909-1291
Phone (865) 584-2146

Hospital & facility affiliations

  • Fort Sanders Regional Medical Center Hospital, Knoxville, TN, CCN 440125
  • Parkwest Medical Center Hospital, Knoxville, TN, CCN 440173

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
25397TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc CurrentSince Jan 1, 2013 Accepting new patients
Covenant Medical Group, Inc. Family Medicine CurrentSince Jan 1, 2013 Accepting new patients

Locations

9330 Park West Blvd
Ste 402
Knoxville, TN 37923
Phone (865) 690-3003

1300 Old Weisgarber Rd
Knoxville, TN 37909
Phone (865) 584-2146

1320 Old Weisgarber Rd
Knoxville, TN 37909
Phone (865) 584-1054

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

Networks

  • MS PPO
  • MS PPO D-SNP
  • MS PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: hicks.james@covenanthealth.cernerdirect.com

Organizations & group practices 2

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": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1023061397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 OLD WEISGARBER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091291",
            "telephone_number": "865-584-2146",
            "fax_number": "865-584-9660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 OLD WEISGARBER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091291",
            "telephone_number": "865-584-2146",
            "fax_number": "865-584-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JAMES",
        "middle_name": "STACY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "25397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3081789",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Hicks.James@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1300 Old Weisgarber Rd",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379091291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.