Active NPI
Alisabeth A. Thurston-Hicks, M.D.
- Psychiatry Physician
- Canon City, CO
National Provider Identifier
1043367634
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 35129
- Practice address
- 3225 Independence Rd
Canon City, CO 81212-9380 - Phone
- (719) 275-2351
- Fax
- (719) 269-9386
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 35129 | CO | Primary |
Addresses
Primary practice location
3225 Independence Rd
Canon City, CO 81212-9380
Mailing address
3225 Independence Rd
Canon City, CO 81212-9380
Phone (719) 275-2351
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01351295 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK
- 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
- Psychiatry
- Education
- University of New Mexico School of Medicine, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1919 Lathrop St
Suite 220
Fairbanks, AK 99701-5942
Phone (907) 452-1739
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairbanks Psychiatric and Neurological Clinic a Prof Corp | Current | Accepting new patients |
Locations
1919 Lathrop St
Ste 220
Fairbanks, AK 99701
Phone (907) 452-1739
1919 Lathrop St
Ste 209
Fairbanks, AK 99701
Phone (907) 452-4446
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.
-
- Neurology Physician
- Fairbanks, AK
- NPI 1518075100
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043367634",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3225 INDEPENDENCE RD",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812129380",
"telephone_number": "719-275-2351",
"fax_number": "719-269-9386"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3225 INDEPENDENCE RD",
"city": "CANON CITY",
"state": "CO",
"postal_code": "812129380",
"telephone_number": "719-275-2351",
"fax_number": "719-269-9386"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THURSTON-HICKS",
"first_name": "ALISABETH",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CO",
"license": "35129",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01351295",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Canon City, CO
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.
- 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.