Thomas Glenn Hicks, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

4301035006 Issued in MI

Practice address

601 John St
Box 42
Kalamazoo, MI 49007-5341

Phone

(269) 341-6417

Fax

(269) 341-8743

NPI assigned

Sep 25, 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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Bronson Practice Management

  • Internal Medicine Physician
  • Kalamazoo, MI
  • NPI 1104840529
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1700986965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 COLUMBIA AVE W",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490153028",
            "telephone_number": "269-965-4500",
            "fax_number": "269-965-1150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "BOX 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-6417",
            "fax_number": "269-341-8743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "THOMAS",
        "middle_name": "GLENN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "4301035006",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0C910950",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1700986965",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBCN",
            "identifier": "TH035006",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Marie Hickman, PHD, ATC
• Sylvia Hicks-Fox, M.D.
• Junelle Hicks
• Raquel Hicks, PT
• Robin Thaniel Hicks
• Kyle Gates Hiestand, CRNA
• Rachel Clare Higgins-Bernhardt, MA, CCC-SLP
• Jane Caroline Higgins, MA
• Kenneth P Highhouse, M.D.
• Robert L Highhouse, M.D.

• General Practice Physician in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• General Practice Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; 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.