Clarence Hicks – Case Management Agency in Byron, GA

Key facts

NPI: 1356783245
Entity type: Individual (NPI type 1)
Primary specialty: Case Management Agency 251B00000X
Practice address: 100 Hamilton Pointe Dr
Suite 115 & 120
Byron, GA 31008
Phone: (478) 477-7531
NPI assigned: Jul 22, 2013
Sex: Male
Sole proprietor: Yes

Organizations & group practices 3

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.

Central Ga Family Therapy Comprehensive Outpatient Rehabilitation Facility (CORF) · Byron, GA · NPI 1316788540

NPD Authorized official
Middle Georgia Family Rehab Comprehensive Outpatient Rehabilitation Facility (CORF) · Byron, GA · NPI 1245672724

NPD (past) CASE MANAGEMENT
Middle Georgia Family Rehab Health Maintenance Organization · Byron, GA · NPI 1366844367

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Practice roles

Organization	Specialty	Status	New patients
Central Ga Family Therapy		Current	Accepting new patients
Middle Georgia Family Rehab	Case Management	Past	Accepting new patients
Middle Georgia Family Rehab		Past	Accepting new patients

Locations

100 Hamilton Pointe Dr
Ste 120
Byron, GA 31008
Phone (478) 538-1436

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Case Management Agency	251B00000X			Yes

Addresses

Primary practice location

100 Hamilton Pointe Dr
Suite 115 & 120
Byron, GA 31008

Mailing address

164 Summer Grove LN
Macon, GA 31206-5234

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 25, 2013.

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374710400000",
    "number": "1356783245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 SUMMER GROVE LN",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312065234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HAMILTON POINTE DR",
            "address_2": "SUITE 115 & 120",
            "city": "BYRON",
            "state": "GA",
            "postal_code": "31008",
            "telephone_number": "478-477-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "CLARENCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-22",
        "last_updated": "2013-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Byron, GA

All providers in Byron, GA · Case Management Agency in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2013. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.