Individual provider Active NPI

Allyson D. Hicks, M.D.

  • Pediatrics Physician
  • Warwick, RI
National Provider Identifier
1417014804
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
08394MD Issued in RI
Practice address
215 Toll Gate Rd
Suite 104
Warwick, RI 02886-4458
Phone
(401) 737-9240
Fax
(401) 739-6413
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

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
Pediatrics Physician 208000000X 08394MD RI Primary

Addresses

Primary practice location

215 Toll Gate Rd
Suite 104
Warwick, RI 02886-4458

Mailing address

215 Toll Gate Rd
Suite 104
Warwick, RI 02886-4458
Phone (401) 737-9240

Other identifiers 1

IdentifierTypeStateIssuer
AH01324MedicaidRI

Other names 1

  • Miss Allyson McCormick Davis Former name

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
08394MDRIMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417014804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 TOLL GATE RD",
            "address_2": "SUITE 104",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864458",
            "telephone_number": "401-737-9240",
            "fax_number": "401-739-6413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 TOLL GATE RD",
            "address_2": "SUITE 104",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864458",
            "telephone_number": "401-737-9240",
            "fax_number": "401-739-6413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "ALLYSON",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "08394MD",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AH01324",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLYSON",
            "last_name": "DAVIS",
            "middle_name": "MCCORMICK",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warwick, RI

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.