Lacy Hicks, CPNP

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

1841362555 Issued in TN

Practice address

2312 Knob Creek Rd Ste 208
Johnson City, TN 37604-2367

Phone

(423) 610-1099

Fax

(423) 246-4300

NPI assigned

Aug 29, 2022

Last updated

Sep 4, 2023By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Regional Allergy & Asthma Center, PC

  • Specialist
  • Kingsport, TN
  • NPI 1174581854

  Single Specialty

  NPD
• Tri-City Pediactric Cardiology P C

  • Pediatric Cardiology Physician
  • Johnson City, TN
  • NPI 1841362555

  Single Specialty

  NPD

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

{
    "created_epoch": "1661731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693785600000",
    "number": "1396465621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312 KNOB CREEK RD STE 208",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042367",
            "telephone_number": "423-610-1099",
            "fax_number": "423-246-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 KNOB CREEK RD STE 208",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042367",
            "telephone_number": "423-610-1099",
            "fax_number": "423-246-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "LACY",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-29",
        "last_updated": "2023-09-04",
        "certification_date": "2023-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "TN",
            "license": "1841362555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1578856985",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1376533489",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://llhicks1.wixsite.com/my-site",
            "affiliation": "N",
            "address_1": "205 Carters Valley Rd",
            "city": "Rogersville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378576310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lori Hess, MS CCC-SLP
• Rick Hess, PHARMD, BC-ADM, CDE
• Andrea Nicole Hetherington, FNPC
• Jackson Hetzler, PHARMD
• Blair Haren Hickman, MSSW LCSW
• Melanie R Hicks, LPC
• Angela D Higgins, P.T.
• Kirsten Higgins, MS, LPC/MHSP
• Highland Springs Medical PC
• Highlands Healthcare LLC

• Pediatric Cardiology Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Pediatric Cardiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2023; 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.