Individual provider Active NPI

Robert C Hicks, MD

  • Emergency Medicine Physician
  • Ogallala, NE
National Provider Identifier
1700945474
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ND-11439-A Issued in NE
Practice address
2601 N Spruce St
Ogallala, NE 69153-2465
Phone
(308) 284-3645
NPI assigned
Dec 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2012

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD00043363 WA
Emergency Medicine Physician 207P00000X E-5163 AR
Emergency Medicine Physician 207P00000X ND-11439-A NE Primary

Addresses

Primary practice location

2601 N Spruce St
Ogallala, NE 69153-2465

Mailing address

826 W 27TH Ave
Spokane, WA 99203-1838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161012001652 IN Practitioner - Emergency Medicine 2062305972 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ND-11439-ANEMDEmergency Medicine Physician
MD00043363WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians of Memphis LLC Emergency Medicine CurrentSince Sep 1, 2016 Accepting new patients
Odessa Physician Associates, PLLC Emergency Medicine Past Accepting new patients
Texas Em-1 Medical Services, PA Past Accepting new patients
East Texas Medical Center Healthcare Associates Emergency Medicine Past Accepting new patients
Hope-Hempstead Emegency Group LLC Emergency Medicine Past Accepting new patients

Locations

1451 N Gardner St
Scottsburg, IN 47170
Phone (812) 752-8500

Organizations & group practices 5

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": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1700945474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 W 27TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992031838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 N SPRUCE ST",
            "city": "OGALLALA",
            "state": "NE",
            "postal_code": "691532465",
            "telephone_number": "308-284-3645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "ROBERT",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD00043363",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-5163",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "ND-11439-A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogallala, NE

Sources for this page

Verify at the official NPI Registry.