NPIMap

Individual provider Active NPI

Clarence Hicks

  • Case Management Agency
  • Byron, GA
National Provider Identifier
1356783245
Registry record updated Jul 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Practice address
100 Hamilton Pointe Dr
Suite 115 & 120
Byron, GA 31008
Phone
(478) 477-7531
NPI assigned
Jul 22, 2013
Last updated
Jul 25, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

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

Mailing address

164 Summer Grove LN
Macon, GA 31206-5234

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

Practice roles

OrganizationSpecialtyStatusNew 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "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

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.