Thomas H Hickerson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD10999 Issued in OR

Practice address

14450 SE Royer Rd
Clackamas, OR 97015-8730

Phone

(503) 658-5521

Fax

(503) 658-5002

NPI assigned

Apr 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281312000000",
    "number": "1700840675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 92900",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972920900",
            "telephone_number": "503-658-5521",
            "fax_number": "503-658-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14450 SE ROYER RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158730",
            "telephone_number": "503-658-5521",
            "fax_number": "503-658-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKERSON",
        "first_name": "THOMAS",
        "middle_name": "H",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2010-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD10999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8438574",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "240325",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adjennis Rivera Hernandez
• Brianna Renee Hernandez
• Michael Kevin Herson, M.D.
• Jennifer Marie Hessick, LMT
• Mai Hey, RPH
• Frances Faline Hicks, M.D.
• Bradley Thomas Higgins, CRNA
• Sharon Marie Higgins, M.D.
• Meghan Higley, MD
• Richard J Hikade, DDS

• Family Medicine Physician in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.