Individual provider Active NPI

Vickie Darlene Hice, OTR/L

  • Pediatric Occupational Therapist
  • Summerville, GA
National Provider Identifier
1124377700
Registry record updated Aug 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Occupational TherapistTaxonomy code 225XP0200X
License
OT003116 Issued in GA
Practice address
1079 Brooks Road
Summerville, GA 30747
Phone
(706) 936-9919
NPI assigned
Aug 29, 2012
Last updated
Aug 29, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT003116 GA
Pediatric Occupational Therapist 225XP0200X OT003116 GA Primary

Addresses

Primary practice location

1079 Brooks Road
Summerville, GA 30747

Mailing address

5050 Highway 100
Summerville, GA 30747
Phone (706) 936-9919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
OT003116GAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1124377700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5050 HIGHWAY 100",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "30747",
            "telephone_number": "706-936-9919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1079 BROOKS ROAD",
            "city": "SUMMERVILLE",
            "state": "GA",
            "postal_code": "30747",
            "telephone_number": "706-936-9919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICE",
        "first_name": "VICKIE",
        "middle_name": "DARLENE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT003116",
            "primary": false
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "GA",
            "license": "OT003116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summerville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.