Individual provider Active NPI

Harlan M Hicks, M.D.

  • Internal Medicine Physician
  • Statesville, NC
National Provider Identifier
1356333876
Registry record updated Apr 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200101216 Issued in NC
Practice address
208 Old Mocksville Rd
Statesville, NC 28625-1930
Phone
(704) 838-8238
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200101216 NC Primary

Addresses

Primary practice location

208 Old Mocksville Rd
Statesville, NC 28625-1930

Mailing address

650 Signal Hill Drive Ext
PO Box 1845
Statesville, NC 28625-4353
Phone (704) 873-4277

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20091216000376 NC Practitioner - Internal Medicine 7113067554 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Virginia School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iredell Physician Network LLCGroup PAC ID 0749345007, 91 clinicians

Practice addresses (Care Compare)

757 Bryant St
Statesville, NC 28677-4142
Phone (704) 873-5658

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Iredell Physician Network LLC CurrentSince Jan 7, 2025 Accepting new patients
Iredell Physician Network LLC CurrentSince Jan 7, 2025 Accepting new patients
Iredell Physician Network LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

766 Hartness Rd
Statesville, NC 28677
Phone (704) 838-2182

757 Bryant St
Statesville, NC 28677
Phone (704) 873-5658

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270598400000",
    "number": "1356333876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 SIGNAL HILL DRIVE EXT",
            "address_2": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286254353",
            "telephone_number": "704-873-4277",
            "fax_number": "704-873-4511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 OLD MOCKSVILLE RD",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286251930",
            "telephone_number": "704-838-8238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "HARLAN",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2010-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "200101216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.