Individual provider Active NPI

Joel Brian Hicks

  • Certified Registered Nurse Anesthetist
  • Fairhope, AL
National Provider Identifier
1023845823
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-164368 Issued in AL
Practice address
750 Morphy Ave
Fairhope, AL 36532-1812
Phone
(251) 928-2375
NPI assigned
Sep 16, 2024
Last updated
Sep 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-164368 AL Primary

Addresses

Primary practice location

750 Morphy Ave
Fairhope, AL 36532-1812

Mailing address

20798 Southwood St
Fairhope, AL 36532-7282
Phone (334) 549-4437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211001704 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 4183150352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Shore Anesthesia, P.C.Group PAC ID 9830089978, 42 clinicians

Practice addresses (Care Compare)

750 Morphy Ave
Fairhope, AL 36532-1812
Phone (251) 990-1109

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-164368ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Shore Anesthesia PC CurrentSince Sep 3, 2024 Accepting new patients

Locations

7101 US Highway 90
Daphne, AL 36526
Phone (251) 625-8400

27961 US Highway 98
Daphne, AL 36526
Phone (251) 435-6850

411 N Section St
Fairhope, AL 36532
Phone (251) 517-5027

750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1023845823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20798 SOUTHWOOD ST",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365327282",
            "telephone_number": "334-549-4437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 MORPHY AVE",
            "city": "FAIRHOPE",
            "state": "AL",
            "postal_code": "365321812",
            "telephone_number": "251-928-2375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JOEL",
        "middle_name": "BRIAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-164368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairhope, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.