Active NPI
Jon Gary Hicks, PHARMACY TECHNICIAN
- Pharmacy Technician
- Birmingham, AL
National Provider Identifier
1306017595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- T02361
- Practice address
- 146 Three Sons Dr
Birmingham, AL 35226-2961 - Phone
- (205) 824-9086
- NPI assigned
- Mar 17, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | T02361 | AL | Primary |
Addresses
Primary practice location
146 Three Sons Dr
Birmingham, AL 35226-2961
Mailing address
146 Three Sons Dr
Birmingham, AL 35226-2961
Phone (205) 824-9086
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3201-0105-0766-335 | Other | DC | PTCB |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T02361 | AL | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205712000000",
"number": "1306017595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "146 THREE SONS DR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352262961",
"telephone_number": "205-824-9086"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "146 THREE SONS DR",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352262961",
"telephone_number": "205-824-9086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "JON",
"middle_name": "GARY",
"name_prefix": "Mr.",
"credential": "PHARMACY TECHNICIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-03-17",
"last_updated": "2008-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "AL",
"license": "T02361",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTCB",
"identifier": "3201-0105-0766-335",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Birmingham, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.