Hickory Family Medical Clinic Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

HICKORY FAMILY MEDICAL CLINIC INC

Practice address

18199 Highway 80
Hickory, MS 39332-3452

Phone

(601) 646-5445

NPI assigned

Nov 16, 2018

Organization subpart

No

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

Authorized official

Name

Andrea Morgan, MDNPI 1770745630

Title

Owner

Phone

(601) 954-8096

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrea Morgan, M.D.

  • Family Medicine Physician
  • Hickory, MS
  • NPI 1770745630
  Medicare reassignment NPD Authorized official
• Cherry Gay Clark, M.D.

  • Family Medicine Physician
  • Hickory, MS
  • NPI 1336251271
  NPD (past)

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

{
    "created_epoch": "1542326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542326400000",
    "number": "1093284366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "HICKORY",
            "state": "MS",
            "postal_code": "393320220",
            "telephone_number": "601-646-5445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18199 HIGHWAY 80",
            "city": "HICKORY",
            "state": "MS",
            "postal_code": "393323452",
            "telephone_number": "601-646-5445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY FAMILY MEDICAL CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-16",
        "last_updated": "2018-11-16",
        "status": "A",
        "authorized_official_last_name": "MORGAN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-954-8096",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherry Gay Clark, M.D.
• Demetra Dawkins-Allen, FNP-BC
• Malori Claire Gallaspy
• Elizabeth Connell Henderson, MD
• Hidden Oaks Transportation LLC
• Hull'S Family Pharmacy
• Independent Living of Ms Homecare,LLC
• Andrea Morgan, M.D.
• Sonji Rose, RN

• Family Medicine Physician in Hickory, MS
• Providers in Hickory, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.