Stuart Hickerson

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

036083126 Issued in IL

Practice address

12528 Sr 78
Havana, IL 62644-6866

Phone

(309) 543-4253

NPI assigned

Aug 21, 2006

Last updated

Dec 13, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/

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.

• Carle Health Medical Group

  dba Carle Physician Group

  • Internal Medicine Physician
  • Urbana, IL
  • NPI 1154653947

  Emergency Medicine

  Medicare reassignment NPD
• Epss LLC - Central Series

  • Emergency Medicine Physician
  • Pekin, IL
  • NPI 1538680467
  Medicare reassignment NPD
• Epss Peoria LLC

  • Emergency Medicine Physician
  • Peoria, IL
  • NPI 1831421056
  Medicare reassignment NPD
• McDonough County Hospital District

  dba McDonough District Hospital

  • General Acute Care Hospital
  • Macomb, IL
  • NPI 1669420766
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • Emergency Care Clinic/Center
  • Peoria, IL
  • NPI 1265966048
  Medicare reassignment NPD
• Methodist Medical Center of Illinois

  • Rehabilitation Hospital Unit
  • Peoria, IL
  • NPI 1982656575
  Medicare reassignment NPD
• Osf Healthcare System

  dba Osf Holy Family Clinics

  • Rural Health Clinic/Center
  • Monmouth, IL
  • NPI 1679606073
  Medicare reassignment NPD
• McDonough County Hospital District

  • Emergency Medicine Physician
  • Macomb, IL
  • NPI 1013048982
  NPD
• McDonough County Hospital District

  dba MDH Community Pharmacy

  • Community/Retail Pharmacy
  • Macomb, IL
  • NPI 1245098458
  NPD
• McDonough County Hospital District

  dba McDonough Medical Group

  • Anatomic Pathology & Clinical Pathology Physician
  • Macomb, IL
  • NPI 1396055869
  NPD
• McDonough County Hospital District

  dba McDonough District Hospital

  • General Acute Care Hospital
  • Macomb, IL
  • NPI 1629227665
  NPD
• McDonough County Hospital District

  dba McDonough District Hospital

  • General Acute Care Hospital
  • Macomb, IL
  • NPI 1790934735
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1073629374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12528 SR 78",
            "city": "HAVANA",
            "state": "IL",
            "postal_code": "626446866",
            "telephone_number": "309-543-4253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKERSON",
        "first_name": "STUART",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036083126",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "IL",
            "license": "036083126",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036083126",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Becky Jane Hart, LCSW
• Havana Cusd 126
• Havana Hco, LLC (Havana Health Care Center)
• Havana Hco, LLC
• Alycia Helling, M.S., CCC-SLP
• Highland Park CVS LLC (CVS Pharmacy # 07610)
• Chase Holtman
• HSHS Medical Group Inc
• Justin Huggins
• Jenna Elizabeth Ishmael, FNP-C

• Emergency Medicine Physician in Havana, IL
• Providers in Havana, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.