Individual provider Active NPI

Lisa Hichkad, NCCPA

  • Physician Assistant
  • Macon, GA
National Provider Identifier
1386840841
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002499 Issued in GA
Practice address
210 Mercer JCT
Macon, GA 31210-4016
Phone
(478) 471-8593
Fax
(478) 471-8599
NPI assigned
Jun 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 002499 GA Primary

Addresses

Primary practice location

210 Mercer JCT
Macon, GA 31210-4016

Mailing address

160 Deer Ridge TRL
Macon, GA 31210-5713
Phone (478) 476-9174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130313000560 GA Practitioner - Physician Assistant 3274778576 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Emory University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thomas C Jones, M.D., P.C.Group PAC ID 2769558030, 13 clinicians

Practice addresses (Care Compare)

265 Sheraton Blvd
Macon, GA 31210-1359
Phone (478) 746-8626

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
002499GAMDPhysician Assistant

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FFBGCD/Endpoint/FFBGCD

Organizations & group practices 1

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.

Hospital & facility affiliations 1

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": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386840841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 DEER RIDGE TRL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312105713",
            "telephone_number": "478-476-9174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 MERCER JCT",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312104016",
            "telephone_number": "478-471-8593",
            "fax_number": "478-471-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICHKAD",
        "first_name": "LISA",
        "credential": "NCCPA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "002499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

Verify at the official NPI Registry.