Organization Active NPI

Karla Hicks Corporation

  • Family Medicine Physician
  • South Bend, IN
National Provider Identifier
1255487476
Registry record updated Aug 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
KARLA HICKS CORPORATION
Practice address
2610 E Jefferson Blvd
South Bend, IN 46615-2724
Phone
(574) 232-3000
Fax
(574) 236-4409
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2007

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

Authorized official

Name
Karla K Hicks
Title
President
Phone
(574) 232-3000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2610 E Jefferson Blvd
South Bend, IN 46615-2724

Mailing address

2610 E Jefferson Blvd
South Bend, IN 46615-2724
Phone (574) 232-3000

Other identifiers 1

IdentifierTypeStateIssuer
000000508824OtherINBC/BS GROUP

National Provider Directory

National Provider Directory

Locations

2610 E Jefferson Blvd
South Bend, IN 46615
Phone (574) 232-3000

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187827200000",
    "number": "1255487476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 E JEFFERSON BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466152724",
            "telephone_number": "574-232-3000",
            "fax_number": "574-236-4409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 E JEFFERSON BLVD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466152724",
            "telephone_number": "574-232-3000",
            "fax_number": "574-236-4409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARLA HICKS CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-08-23",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-232-3000"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS GROUP",
            "identifier": "000000508824",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; 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.