Individual provider Active NPI

Rachael Nicole Hixson, OD

  • Optometrist
  • Gilmer, TX
National Provider Identifier
1114589132
Registry record updated Jun 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
9732T Issued in TX
Practice address
101 Simpson St
Gilmer, TX 75644-2231
Phone
(903) 843-5400
NPI assigned
Jun 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 9732T TX Primary

Addresses

Primary practice location

101 Simpson St
Gilmer, TX 75644-2231

Mailing address

102 S Gaston St Apt 12
Carthage, TX 75633-2858
Phone (904) 504-3615

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250110001492 TX Practitioner - Optometry 9133657778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Abc EyecareGroup PAC ID 0547619918, 3 clinicians

Practice addresses (Care Compare)

136 Shelley Dr
Tyler, TX 75701-8723
Phone (903) 561-8686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9732TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Eyecare Optometrist CurrentSince Jan 1, 2025 Accepting new patients

Locations

136 Shelley Dr
Tyler, TX 75701
Phone (903) 561-8686

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.

NPI Registry JSON

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

{
    "created_epoch": "1561766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561766400000",
    "number": "1114589132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 S GASTON ST APT 12",
            "city": "CARTHAGE",
            "state": "TX",
            "postal_code": "756332858",
            "telephone_number": "904-504-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SIMPSON ST",
            "city": "GILMER",
            "state": "TX",
            "postal_code": "756442231",
            "telephone_number": "903-843-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIXSON",
        "first_name": "RACHAEL",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-29",
        "last_updated": "2019-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9732T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilmer, TX

Sources for this page

Verify at the official NPI Registry.