Organization Active NPI

Branches of Hickory Healthcare PLLC

  • Family Medicine Physician
  • Hickory, NC
National Provider Identifier
1659025393
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BRANCHES OF HICKORY HEALTHCARE PLLC
Practice address
912 2ND St NE Ste 4
Hickory, NC 28601-3851
Phone
(828) 979-0955
Fax
(828) 212-4296
NPI assigned
Feb 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Authorized official

Name
Amanda Harris, NPNPI 1770934713
Title
Owner
Phone
(828) 979-0955

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 Primary

Addresses

Primary practice location

912 2ND St NE Ste 4
Hickory, NC 28601-3851

Mailing address

2425 N Center St # 117
Hickory, NC 28601-1320
Phone (828) 979-0955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221216001387 NC Part B Supplier - Clinic/Group Practice 4486023207 Receives reassigned benefits from 1 practitioner
Practice locations: Hickory, NC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2262007Branches of Hickory Healthcare, PLLC912 2ND St NE Suite 4, Hickory, NC 28601Certificate of waiverJun 7, 2028

National Provider Directory

National Provider Directory

Locations

912 2nd St NE
Ste 4
Hickory, NC 28601
Phone (828) 979-0955

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": "1644537600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1659025393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 N CENTER ST # 117",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286011320",
            "telephone_number": "828-979-0955",
            "fax_number": "828-212-4296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 2ND ST NE STE 4",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286013851",
            "telephone_number": "828-979-0955",
            "fax_number": "828-212-4296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANCHES OF HICKORY HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-11",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-979-0955",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.