Connie Fairley Hicks, DNP-NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5004262 Issued in NC

Practice address

3801 Lake Boone TRL
Suite G
Raleigh, NC 27607-2934

Phone

(919) 865-8710

Fax

(919) 256-0772

NPI assigned

Jan 23, 2009

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

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Nurse Practitioner

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/11901/brand/1/csg/1/fhir/r4

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.

• Relief Integrated Healthcare

  • Psychiatric/Mental Health Nurse Practitioner
  • Louisburg, NC
  • NPI 1184143224
  Medicare reassignment Authorized official
• The Hope Centre for Advancement, LLC

  • Medical Specialty Clinic/Center
  • Durham, NC
  • NPI 1164724795
  Medicare reassignment NPD
• Vision Behavioral Health Services

  • Community/Behavioral Health Agency
  • Louisburg, NC
  • NPI 1588974158
  Medicare reassignment NPD
• Louisburg Family Practice and Pain Management PLLC

  • Family Medicine Physician
  • Louisburg, NC
  • NPI 1295063279
  NPD (past)
• Louisburg PPM LLC

  • Family Medicine Physician
  • Louisburg, NC
  • NPI 1720225691
  NPD (past)

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

{
    "created_epoch": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1649418971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 LAKE BOONE TRL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276072934",
            "telephone_number": "919-856-8710",
            "fax_number": "919-256-0772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 LAKE BOONE TRL",
            "address_2": "SUITE G",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276072934",
            "telephone_number": "919-865-8710",
            "fax_number": "919-256-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "CONNIE",
        "middle_name": "FAIRLEY",
        "credential": "DNP-NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-23",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Hicks
• Beverly June Hicks, M.D., LPC
• Bria Brown Hicks, FNP-C
• Brianna Hicks
• Brianna Hicks, LCMHC
• Cuong Hicks, RPH
• Grace D Hicks, MACCCSLP
• Hannah Lindsey Hicks, RD, LDN
• Jacqueline Michele Hicks, D.O.
• Jeremy Michael Hicks

• Nurse Practitioner in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.