Mack L Hicks, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15018 Issued in TN

Practice address

444 Clinchfield Street
Suite 201
Kingsport, TN 37660-3606

Phone

(423) 230-2100

Fax

(423) 230-2112

NPI assigned

Jul 7, 2006

Last updated

Jan 3, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Family PracticeAlso: Addiction Medicine

Education

University of Tennessee, HSC, College of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Savida Health PCGroup PAC ID 4082809967, shared by 7 NPIs, 89 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

35.98 of 100Reported as group

Quality

0

Promoting interoperability

0

Improvement activities

20

Cost

78.28

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24804/brand/1/csg/21/fhir/r4
• Direct secure messaging: mack.hicks.1@24804.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Savida Health,PC

  • Addiction Medicine (Internal Medicine) Physician
  • Bristol, TN
  • NPI 1861118846
  Medicare reassignment NPD
• Savida Health, PC

  • Addiction Medicine (Internal Medicine) Physician
  • Woodbridge, VA
  • NPI 1548739170
  Medicare reassignment NPD
• Optimum Primary Care PC

  • Family Medicine Physician
  • Kingsport, TN
  • NPI 1952728289
  NPD Authorized official
• Savida Health, PC

  • Addiction Medicine (Internal Medicine) Physician
  • Gilford, NH
  • NPI 1285388546
  NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1154354900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 CLINCHFIELD STREET",
            "address_2": "SUITE 201",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603606",
            "telephone_number": "423-230-2100",
            "fax_number": "423-230-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 CLINCHFIELD STREET",
            "address_2": "SUITE 201",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603606",
            "telephone_number": "423-230-2100",
            "fax_number": "423-230-2112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "MACK",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "15018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy Hess, PT
• Sarah N. Hewitt
• Hannah Hicks
• Ian Jackson Hicks, RN
• Luke Evan Hicks
• Highlands Pathology Consultants, P.C.
• Jason A. Hill, M.D.
• Joseph Hill, D.O.
• Robin Lynn Hill, BSW
• Rhonda C. Hillman, NP

• Family Medicine Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.