NPIMap

Individual provider Active NPI

Constance Smith-Hicks, M.D.

  • Neurology with Special Qualifications in Child Neurology Physician
  • Baltimore, MD
National Provider Identifier
1386866564
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
D65871 Issued in MD
Practice address
200 N Wolfe St
Suite 2147
Baltimore, MD 21287-0001
Phone
(410) 955-7212
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X D65871 MD
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X D65871 MD Primary

Addresses

Primary practice location

200 N Wolfe St
Suite 2147
Baltimore, MD 21287-0001

Mailing address

6201 Greenleigh Ave
Middle River, MD 21220-2004
Phone (410) 933-6423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070801000526 MD Practitioner - Neurology 1254422553 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Columbia University College of Physicians and Surgeons, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kennedy Krieger AssociatesGroup PAC ID 1759280597, 73 clinicians

Practice addresses (Care Compare)

707 N Broadway
Baltimore, MD 21205-1832
Phone (443) 923-9200

Hospital & facility affiliations

  • Kennedy Krieger Institute Hospital, Baltimore, MD, CCN 213301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D65871MDMDNeurology with Special Qualifications in Child Neurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Johns Hopkins University Neurology CurrentSince Jul 15, 2016 Accepting new patients
Johns Hopkins University Current Accepting new patients
Johns Hopkins University CurrentSince Jul 15, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

200 N Wolfe St
Ste 2147
Baltimore, MD 21287
Phone (410) 955-7212

600 N Wolfe St
Baltimore, MD 21287

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

Interoperability endpoints

  • Direct secure messaging: csmithhicks8893@direct.kennedykrieger.org

Organizations & group practices 5

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.

Hospital & facility affiliations 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1386866564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 GREENLEIGH AVE",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202004",
            "telephone_number": "410-933-6423",
            "fax_number": "410-500-4266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N WOLFE ST",
            "address_2": "SUITE 2147",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212870001",
            "telephone_number": "410-955-7212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-HICKS",
        "first_name": "CONSTANCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "D65871",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MD",
            "license": "D65871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.