Organization Active NPI

Port City Orthopaedics PLLC

  • Orthopaedic Surgery Physician
  • Wrightsville Beach, NC
National Provider Identifier
1255353298
Registry record updated Jul 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
PORT CITY ORTHOPAEDICS PLLC
Practice address
206 Causeway Dr Unit 232
Wrightsville Beach, NC 28480-1759
Phone
(910) 791-4492
Fax
(000) 000-0000
NPI assigned
Jul 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2025

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

Authorized official

Name
Dr. Derrick Gerard Hickey, MDNPI 1356376289
Title
President
Phone
(910) 791-4492

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

206 Causeway Dr Unit 232
Wrightsville Beach, NC 28480-1759

Mailing address

Co D Hickey, President
6101 Old Branch Rd
Wilmington, NC 28409
Phone (910) 791-4492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061121000105 NC Part B Supplier - Clinic/Group Practice 1951309228 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmington, NC

National Provider Directory

National Provider Directory

Locations

5302 Oleander Dr
Wilmington, NC 28403
Phone (910) 452-7899

5305 Wrightsville Ave
Ste G
Wilmington, NC 28403
Phone (910) 452-8572

5305 Wrightsville Ave
Ste H
Wilmington, NC 28403
Phone (910) 452-8572

206 Causeway Dr
Unit 232
Wrightsville Beach, NC 28480
Phone (910) 791-4492

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753315200000",
    "number": "1255353298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "CO D HICKEY, PRESIDENT",
            "address_2": "6101 OLD BRANCH RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "28409",
            "telephone_number": "910-791-4492",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CAUSEWAY DR UNIT 232",
            "city": "WRIGHTSVILLE BEACH",
            "state": "NC",
            "postal_code": "284801759",
            "telephone_number": "910-791-4492",
            "fax_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORT CITY ORTHOPAEDICS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "HICKEY",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "GERARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "910-791-4492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wrightsville Beach, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.