NPIMap

Organization Active NPI

Kevin B. Hicks, D.O.,P.C.

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1538347398
Registry record updated Mar 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
52959 Issued in GA
Legal business name
KEVIN B. HICKS, D.O.,P.C.
Doing business as
FAMILY PRACTICE AT PEACHTREE-DUNWOODY
Practice address
6105 Peachtree Dunwoody Rd Ste C115
Atlanta, GA 30328-5943
Phone
(770) 481-0019
Fax
(770) 481-0408
NPI assigned
Feb 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2019

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

Authorized official

Name
Dr. Kevin B. Hicks, D.O.NPI 1982704789
Title
Physician
Phone
(770) 481-0019

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 52959 GA Primary

Addresses

Primary practice location

6105 Peachtree Dunwoody Rd Ste C115
Atlanta, GA 30328-5943

Mailing address

6105 Peachtree Dunwoody Rd Ste C115
Atlanta, GA 30328-5943
Phone (770) 481-0019

Other identifiers 1

IdentifierTypeStateIssuer
6643OtherGAMEDICARE GROUP NUMBER

Other names 1

  • FAMILY PRACTICE AT PEACHTREE-DUNWOODY Doing business as

National Provider Directory

National Provider Directory

Locations

6105 Peachtree Dunwoody Rd
Ste C115
Sandy Springs, GA 30328
Phone (770) 481-0019

Practitioners & affiliated clinicians

Practitioners 1

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": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1538347398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6105 PEACHTREE DUNWOODY RD STE C115",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285943",
            "telephone_number": "770-481-0019",
            "fax_number": "770-481-0408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6105 PEACHTREE DUNWOODY RD STE C115",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303285943",
            "telephone_number": "770-481-0019",
            "fax_number": "770-481-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN B. HICKS, D.O.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "770-481-0019",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "52959",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "6643",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY PRACTICE AT PEACHTREE-DUNWOODY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAMILY PRACTICE AT PEACHTREE-DUNWOODY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.