Active NPI
Leon P Hickey, DPM
- Podiatrist
- Kennebunk, ME
National Provider Identifier
1689604282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 1052
- Practice address
- 7 Shape Dr
Kennebunk, ME 04043-6601 - Phone
- (207) 985-7174
- Fax
- (207) 985-1304
- NPI assigned
- Jul 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 1052 | ME | Primary |
Addresses
Primary practice location
7 Shape Dr
Kennebunk, ME 04043-6601
Mailing address
7 Shape Dr
Kennebunk, ME 04043-6601
Phone (207) 985-7174
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 431833399 | Medicaid | ME |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Medical Group Department of Goodall Hospital | Past | Accepting new patients | |
| Mousam Valley Orthopaedics PA | Past | Accepting new patients |
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.
-
- Orthopaedic Surgery Physician
- Sanford, ME
- NPI 1043374044
-
- Family Medicine Physician
- Kennebunk, ME
- NPI 1356356869
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242777600000",
"number": "1689604282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 SHAPE DR",
"city": "KENNEBUNK",
"state": "ME",
"postal_code": "040436601",
"telephone_number": "207-985-7174",
"fax_number": "207-985-1304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 SHAPE DR",
"city": "KENNEBUNK",
"state": "ME",
"postal_code": "040436601",
"telephone_number": "207-985-7174",
"fax_number": "207-985-1304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKEY",
"first_name": "LEON",
"middle_name": "P",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2009-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "ME",
"license": "1052",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "431833399",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kennebunk, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.