Active NPI
Peggy Ann Hickey, M.D.
- Pediatrics Physician
- Minnetonka, MN
National Provider Identifier
1689646986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 32154
- Practice address
- 17705 Hutchins Dr
Minnetonka, MN 55345-4145 - Phone
- (952) 401-8300
- NPI assigned
- Feb 2, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 32154 | MN | Primary |
Addresses
Primary practice location
17705 Hutchins Dr
Minnetonka, MN 55345-4145
Mailing address
2805 Campus Dr
Plymouth, MN 55441-2676
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100451 | Other | MN | UCARE |
| 1215226 | Other | MN | MEDICA |
| CP9040844011 | Other | MN | PREFERREDONE |
| 14977HI | Other | MN | BLUE CROSS |
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
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Urgent Care Doctors Office, PA | Pediatrics | Past | Accepting new patients |
Organizations & group practices 1
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": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1689646986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2805 CAMPUS DR",
"city": "PLYMOUTH",
"state": "MN",
"postal_code": "554412676"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17705 HUTCHINS DR",
"city": "MINNETONKA",
"state": "MN",
"postal_code": "553454145",
"telephone_number": "952-401-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKEY",
"first_name": "PEGGY",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-02",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MN",
"license": "32154",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE",
"identifier": "100451",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "1215226",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERREDONE",
"identifier": "CP9040844011",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "14977HI",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Minnetonka, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.