Theresa Isabella Hicks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

001011935 Issued in NC

Practice address

1665 Herlong CT Ste B
Rock Hill, SC 29732-1193

Phone

(704) 335-9794

NPI assigned

Jan 25, 2021

Last updated

Sep 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1611532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1184214066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9104 BLUE RIDGE DR",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297072510",
            "telephone_number": "919-564-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1665 HERLONG CT STE B",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297321193",
            "telephone_number": "704-335-9794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "THERESA",
        "middle_name": "ISABELLA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-25",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001011935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine Sullivan Hicklin, D.P.T.
• Kia Catoe Hicklin
• Leland Hicklin
• Bevelyn Hicks
• Molly M Hicks, AUD
• Hidden Sentence the Rehab Period
• Christine Nicole High, RN
• James Hartwell Hildebrand, OD
• Linda Hill, B.A.
• Olivia Frances Hill, PHARMD

• Physician Assistant in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Physician Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.