Individual provider Active NPI

Michael Patrick Hicks

  • Pharmacist
  • Sidney, NE
National Provider Identifier
1124686746
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
16412 Issued in NE
Practice address
1944 Illinois St
Sidney, NE 69162-1427
Phone
(308) 254-4531
NPI assigned
May 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 16412 NE Primary

Addresses

Primary practice location

1944 Illinois St
Sidney, NE 69162-1427

Mailing address

1944 Illinois St
Sidney, NE 69162-1427
Phone (308) 254-4531

Other practice location 1

538 E Pinewood Ave
Seward, NE 68434-1152
Phone (402) 212-7980

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
16412NEMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Safeway Inc Past Accepting new patients
Safeway Inc Past Accepting new patients

Organizations & group practices 2

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": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559088000000",
    "number": "1124686746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1944 ILLINOIS ST",
            "city": "SIDNEY",
            "state": "NE",
            "postal_code": "691621427",
            "telephone_number": "308-254-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1944 ILLINOIS ST",
            "city": "SIDNEY",
            "state": "NE",
            "postal_code": "691621427",
            "telephone_number": "308-254-4531"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "538 E Pinewood Ave",
            "address_purpose": "LOCATION",
            "city": "Seward",
            "state": "NE",
            "postal_code": "684341152",
            "country_code": "US",
            "telephone_number": "402-212-7980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HICKS",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NE",
            "license": "16412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.