NPIMap

Organization Active NPI

Edgar Hicks, MD, LLC

  • Orthopaedic Surgery Physician
  • Eau Claire, WI
National Provider Identifier
1487748539
Registry record updated Jun 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
21719-020 Issued in WI
Legal business name
EDGAR HICKS, MD, LLC
Practice address
836 Richard Dr
Eau Claire, WI 54701-6242
Phone
(715) 834-2701
Fax
(715) 834-2972
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2008

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

Authorized official

Name
Dr. Edgar O Hicks, M.D.NPI 1538190483
Title
President/Owner
Phone
(715) 834-2701

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 21719-020 WI Primary

Addresses

Primary practice location

836 Richard Dr
Eau Claire, WI 54701-6242

Mailing address

836 Richard Dr
Eau Claire, WI 54701-6242
Phone (715) 834-2701

Other identifiers 1

IdentifierTypeStateIssuer
30187000MedicaidWI

Other names 1

  • Hicks Orthopedic Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

2809 E Hamilton Ave
Eau Claire, WI 54701
Phone (715) 619-8820

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213660800000",
    "number": "1487748539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "836 RICHARD DR",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016242",
            "telephone_number": "715-834-2701",
            "fax_number": "715-834-2972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 RICHARD DR",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016242",
            "telephone_number": "715-834-2701",
            "fax_number": "715-834-2972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDGAR HICKS, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-06-17",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "715-834-2701",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "WI",
            "license": "21719-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30187000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hicks Orthopedic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eau Claire, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; 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.