Jacqueline Michele Hicks, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2011-00037 Issued in NC

Practice address

10010 Falls of Neuse Rd
Raleigh, NC 27614-8494

Phone

(919) 848-6946

NPI assigned

Jun 15, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Osteopathic Manipulative Medicine

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Carolina Physical Therapy Associates LLCGroup PAC ID 7012989684, shared by 7 NPIs, 496 clinicians

Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wakemed, Raleigh Campus Hospital, Raleigh, NC, CCN 340069
• Duke University Hospital Hospital, Durham, NC, CCN 340030

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jhicks80075@directhisp.wakemed.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wake Specialty Physicians, LLC

  • Surgery Physician
  • Raleigh, NC
  • NPI 1942440375

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Wake Specialty Physicians LLC

  • Internal Medicine Physician
  • Raleigh, NC
  • NPI 1134530074

  Family Medicine

  NPD
• Boice-Willis Clinic, PA

  • Physical Therapy Clinic/Center
  • Rocky Mount, NC
  • NPI 1952557241
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Duke University Health System Inc

  • Rehabilitation Hospital Unit
  • Raleigh, NC
  • NPI 1205225646
  Care Compare affiliation
• Duke University Health System Inc

  • Clinical Medical Laboratory
  • Raleigh, NC
  • NPI 1306828108

  Hospital

  Care Compare affiliation
• Duke University Health System Inc

  • Clinical Medical Laboratory
  • Durham, NC
  • NPI 1508847047

  Hospital

  Care Compare affiliation
• Duke University Health System, Inc.

  • Land Ambulance
  • Durham, NC
  • NPI 1417954942

  Hospital

  Care Compare affiliation
• Duke University Health System, Inc.

  • Rehabilitation Hospital Unit
  • Durham, NC
  • NPI 1538166061
  Care Compare affiliation
• Duke University Health System, Inc.

  • General Acute Care Hospital
  • Durham, NC
  • NPI 1992703540
  Care Compare affiliation
• Wakemed

  • Psychiatric Hospital Unit
  • Raleigh, NC
  • NPI 1780446302
  Care Compare affiliation
• Wakemed

  • General Acute Care Hospital
  • Raleigh, NC
  • NPI 1972579837
  Care Compare affiliation

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

{
    "created_epoch": "1213488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702339200000",
    "number": "1326208117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 602195",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282602195",
            "telephone_number": "919-350-0351",
            "fax_number": "919-350-7687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 FALLS OF NEUSE RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276148494",
            "telephone_number": "919-848-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JACQUELINE",
        "middle_name": "MICHELE",
        "name_prefix": "Mrs.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-15",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2011-00037",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0116020657",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "241298",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1326208117",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0012104",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9092685",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brianna Hicks, LCMHC
• Connie Fairley Hicks, DNP-NP
• Cuong Hicks, RPH
• Grace D Hicks, MACCCSLP
• Hannah Lindsey Hicks, RD, LDN
• Jeremy Michael Hicks
• Kiamesha Diamond Hicks
• Kwameshia Teonne Hicks, NP-C
• Letitia Hicks
• Maya Elaine Hicks, MS,LAT,ATC

• Family Medicine Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.