Individual provider Active NPI

Nance D Hicks, D0

  • Family Medicine Physician
  • Granbury, TX
National Provider Identifier
1588656409
Registry record updated Jul 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R2620 Issued in TX
Practice address
100 Gateway Hills LN
Granbury, TX 76049-7846
Phone
(817) 383-4566
Fax
(817) 359-3675
NPI assigned
Aug 17, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X R2620 TX Primary

Addresses

Primary practice location

100 Gateway Hills LN
Granbury, TX 76049-7846

Mailing address

1710 Keller Pkwy # 1685
Keller, TX 76248-3749
Phone (817) 383-4566

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 1, 2022 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
3975OKMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
McDavid M. Mahaffey, M.D., P.a. Family Medicine Past Accepting new patients
True Med Direct, PLLC Past Accepting new patients
Gemini Medical Group Inc Family Medicine Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: drhicks@direct.meditouchehr.com
  • Direct secure messaging: nance.hicks.1@24667.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/24667/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783382400000",
    "number": "1588656409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 KELLER PKWY # 1685",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762483749",
            "telephone_number": "817-383-4566",
            "fax_number": "817-259-2675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 GATEWAY HILLS LN",
            "city": "GRANBURY",
            "state": "TX",
            "postal_code": "760497846",
            "telephone_number": "817-383-4566",
            "fax_number": "817-359-3675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "NANCE",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D0",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-17",
        "last_updated": "2026-07-07",
        "certification_date": "2026-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "R2620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Granbury, TX

Sources for this page

Verify at the official NPI Registry.