Brian Hicks, MLS

Primary specialty

Medical TechnologistTaxonomy code 246QM0706X

License

25357723

Practice address

10 Wendell Avenue Ext Ste 105
Pittsfield, MA 01201-6283

Phone

(413) 464-7521

Fax

(877) 208-8430

NPI assigned

Jan 29, 2013

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Clean Image

  • Clinical Medical Laboratory
  • Pittsfield, MA
  • NPI 1497096960
  NPD (past) Authorized official

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

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1356689152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 WENDELL AVENUE EXT STE 105",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012016283",
            "telephone_number": "413-464-7521",
            "fax_number": "877-208-8430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 WENDELL AVENUE EXT STE 105",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012016283",
            "telephone_number": "413-464-7521",
            "fax_number": "877-208-8430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "BRIAN",
        "name_prefix": "Mr.",
        "credential": "MLS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": null,
            "license": "25357723",
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "22D2047480",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1497096960",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Hersey
• Caitlin Conte Hertz, RN
• Adam Thomas Hetland, DO
• Eliza Rhodes Hewat, LMHC
• Eugene H Heyman, M.D.
• Hannah May Hicks, PA-C
• Briana E Higgins, MSW, LCSW
• Holly Higinbotham, PSYD
• Amanda Hill, CPNP
• Michelle Deanne Hill

• Medical Technologist in Pittsfield, MA
• Providers in Pittsfield, MA by specialty
• Medical Technologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2013; 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.