Kenneth Lee Hicks Jr., D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2728 Issued in NC

Practice address

610 Old Tar Village Rd Ste E
Winterville, NC 28590-7936

Phone

(252) 215-0990

Fax

(252) 215-0922

NPI assigned

Nov 16, 2005

Last updated

Jan 23, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Hicks Chiropractic, P.a.

  • Clinic/Center
  • Winterville, NC
  • NPI 1245334747
  Authorized official Same address or phone

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201046400000",
    "number": "1235111287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 OLD TAR VILLAGE RD STE E",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285907936",
            "telephone_number": "252-215-0990",
            "fax_number": "252-215-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 OLD TAR VILLAGE RD STE E",
            "city": "WINTERVILLE",
            "state": "NC",
            "postal_code": "285907936",
            "telephone_number": "252-215-0990",
            "fax_number": "252-215-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "KENNETH",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2008-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890839U",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Harris Transport Solutions LLC
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• Heavenly Blessed Home Care
• Hicks Chiropractic, P.a.
• Jenna Hilgoe, BCBA
• Reshonda Holley
• Courtney Marie Holster, COTA/L
• Home Life Care Inc
• James Hood, EMT-PARAMEDIC

• Chiropractor in Winterville, NC
• Providers in Winterville, NC by specialty
• Chiropractor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; 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.