Active NPI
James Stacy Hicks, M.D.
- Family Medicine Physician
- Knoxville, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 25397
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3081789 | Medicaid | TN |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
Enrollment records 1
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
Practice addresses (Care Compare)
1300 Old Weisgarber Rd
Knoxville, TN 37909-1291
Phone (865) 584-2146
Hospital & facility affiliations
- Fort Sanders Regional Medical Center
- Parkwest Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Colonoscopy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25397 | TN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Covenant Medical Group, Inc | Current | Accepting new patients | |
| Covenant Medical Group, Inc. | Family Medicine | Current | 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
- 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.
-
- Family Medicine Physician
- Knoxville, TN
- NPI 1457302010
-
- Durable Medical Equipment & Medical Supplies
- Knoxville, TN
- NPI 1871269415
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Knoxville, TN
- NPI 1942294814
-
- General Acute Care Hospital
- Knoxville, TN
- NPI 1396739165
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.