Lisa M Hicks, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

1-109237 Issued in AL

Practice address

126 Clinic Dr
Dothan, AL 36303-1980

Phone

(334) 793-1881

Fax

(334) 340-5918

NPI assigned

Mar 23, 2012

Last updated

Jul 6, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisahicks@dpc.allscriptsdirect.net

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.

• Dothan Pediatric Clinic, P. a.

  • Pediatrics Physician
  • Dothan, AL
  • NPI 1376508788
  Medicare reassignment NPD

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499299200000",
    "number": "1497021414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 CLINIC DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031980",
            "telephone_number": "334-793-1881",
            "fax_number": "334-340-5918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 CLINIC DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031980",
            "telephone_number": "334-793-1881",
            "fax_number": "334-340-5918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "LISA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2017-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-109237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196555",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wendy Herring, PHARMD
• Linda Hetrick, LPN
• Benjamin Hewitt, MD
• Alice M Hickey, CRNA
• Michelle Hickman
• Olivia Lauren Hicks
• Isabella Rene Hildreth, DPT
• Bentley K Hill
• Burton L Hill, RPH
• Mackenzie Erin Hill, PHARMD

• Pediatric Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.