Hickham Dermatology and Med Spa LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

HICKHAM DERMATOLOGY AND MED SPA LLC

Practice address

4141 Bienville St Ste 108
New Orleans, LA 70119-5149

Phone

(504) 258-0244

NPI assigned

Jan 18, 2018

Organization subpart

No

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

Authorized official

Name

Mrs. Patricia Rice Hickham, MDNPI 1073682084

Title

Owner/MD

Phone

(504) 258-0244

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

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

• Patricia R Hickham, M.D.

  • Dermatology Physician
  • New Orleans, LA
  • NPI 1073682084
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1516233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516665600000",
    "number": "1114435690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4141 BIENVILLE ST STE 108",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701195149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4141 BIENVILLE ST STE 108",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701195149",
            "telephone_number": "504-258-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKHAM DERMATOLOGY AND MED SPA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-18",
        "last_updated": "2018-01-23",
        "status": "A",
        "authorized_official_last_name": "HICKHAM",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "RICE",
        "authorized_official_title_or_position": "OWNER/MD",
        "authorized_official_telephone_number": "504-258-0244",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kortney Hickenbottom
• Kierra Hickerson
• Michael Hickerson, MSW RSW
• Rozie' Hickerson, MPA
• Bryn Hickey, LPCC
• Patricia R Hickham, M.D.
• Tyler Hicklin
• Areana Hickman
• Dean A Hickman, MD
• Brandon Lee Hicks, MD

• Dermatology Physician in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Dermatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.