Madeline M Hicks, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4498 Issued in KY

Practice address

University of Louisville School of Dentistry
501 S. Preston St.
Louisville, KY 40292-0001

Phone

(502) 852-5128

Fax

(502) 852-7163

NPI assigned

Sep 6, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366545204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF LOUISVILLE SCHOOL OF DENTISTRY",
            "address_2": "501 S. PRESTON ST.",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402920001",
            "telephone_number": "502-852-5128",
            "fax_number": "502-852-7163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF LOUISVILLE SCHOOL OF DENTISTRY",
            "address_2": "501 S. PRESTON ST.",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402920001",
            "telephone_number": "502-852-5128",
            "fax_number": "502-852-7163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "MADELINE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "4498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORAL",
            "identifier": "0004569",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60044989",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda B Hicks, DNP, APRN, FNP-C
• Ashton Hicks, PT, DPT
• Connor Hicks
• David Lawrence Hicks, MD
• Kaitlyn Hicks, FNP-C
• Matthew Hicks, M.D.
• Michelle Rae Hicks, ICADC, CADC
• Ronald Tyrone Hicks Sr., RADPSS
• Scott Glen Hicks, APRN
• Thanh Lien Hicks, DPT

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.