Active NPI
William E. Hicks, M. D.
- Family Medicine Physician
- Willmar, MN
National Provider Identifier
1164422176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 18381
- Practice address
- 101 Willmar Avenue SW
Willmar, MN 56201-3591 - Phone
- (320) 231-5000
- Fax
- (320) 231-5067
- NPI assigned
- Aug 1, 2005
- Last updated
- Jun 16, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 18381 | IA | Primary |
Addresses
Primary practice location
101 Willmar Avenue SW
Willmar, MN 56201-3591
Mailing address
101 Willmar Avenue SW
Willmar, MN 56201-3591
Phone (320) 231-5000
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18381 | IA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Medicine Clinic | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Physician Assistant
- Sibley, IA
- NPI 1992023642
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276646400000",
"number": "1164422176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 WILLMAR AVENUE SW",
"city": "WILLMAR",
"state": "MN",
"postal_code": "562013591",
"telephone_number": "320-231-5000",
"fax_number": "320-231-5067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WILLMAR AVENUE SW",
"city": "WILLMAR",
"state": "MN",
"postal_code": "562013591",
"telephone_number": "320-231-5000",
"fax_number": "320-231-5067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "WILLIAM",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "M. D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-01",
"last_updated": "2010-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "IA",
"license": "18381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Willmar, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.