Individual provider Active NPI

James Edward Hicks, D.C.

  • Chiropractor
  • Salem, VA
National Provider Identifier
1679637623
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0104557201 Issued in VA
Practice address
1461 W Main St
Salem, VA 24153-3120
Phone
(540) 375-9220
Fax
(434) 793-9315
NPI assigned
Dec 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 0104557201 VA Primary
Chiropractor 111N00000X 4710 NC

Addresses

Primary practice location

1461 W Main St
Salem, VA 24153-3120

Mailing address

PO Box 681789
Franklin, TN 37068-1789
Phone (615) 435-0584

Other identifiers 5

IdentifierTypeStateIssuer
52222642800OtherOHBWC NUMBER
0261103MedicaidOH
000000204939OtherOHANTHEM BLUE CROSS BLUE SH
522226428OtherOHTAX I.D.
522226428027OtherOHCARESOURCE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150616001162 VA Practitioner - Chiropractic 3375442221 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4710NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Coremedx Inc. Chiropractor CurrentSince Jul 5, 2022 Accepting new patients
James E. Hicks, D.C., Inc. Chiropractor CurrentSince Apr 1, 2000 Accepting new patients

Locations

6480 E Main St
Ste B
Reynoldsburg, OH 43068
Phone (614) 864-1611

6400 E Main St
Reynoldsburg, OH 43068
Phone (614) 864-1611

441 Piney Forest Rd
Ste E
Danville, VA 24540
Phone (434) 791-4110

441 Piney Forest Rd
Ste G
Danville, VA 24540
Phone (434) 793-0700

1461 W Main St
Salem, VA 24153
Phone (540) 375-9220

Organizations & group practices 2

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": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1679637623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681789",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370681789",
            "telephone_number": "615-435-0584",
            "fax_number": "615-435-0549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 W MAIN ST",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241533120",
            "telephone_number": "540-375-9220",
            "fax_number": "434-793-9315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104557201",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4710",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BWC NUMBER",
            "identifier": "52222642800",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0261103",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS BLUE SH",
            "identifier": "000000204939",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX I.D.",
            "identifier": "522226428",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "522226428027",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.