Individual provider Active NPI

Todd G Hickox, DO

  • Cardiovascular Disease Physician
  • Lansing, MI
National Provider Identifier
1174521041
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
5101008734 Issued in MI
Practice address
1140 E Michigan Ave Ste 400
Lansing, MI 48912-1806
Phone
(517) 364-9650
Fax
(517) 364-9605
NPI assigned
Jul 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 5101008734 MI Primary

Addresses

Primary practice location

1140 E Michigan Ave Ste 400
Lansing, MI 48912-1806

Mailing address

3301 E Michigan Ave Ste a
Lansing, MI 48912-4641
Phone (517) 253-3633

Other identifiers 1

IdentifierTypeStateIssuer
2987950MedicaidMI

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 Osteopathy

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1174521041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 E MICHIGAN AVE STE A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489124641",
            "telephone_number": "517-253-3633",
            "fax_number": "517-253-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E MICHIGAN AVE STE 400",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121806",
            "telephone_number": "517-364-9650",
            "fax_number": "517-364-9605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKOX",
        "first_name": "TODD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MI",
            "license": "5101008734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2987950",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.