Individual provider Active NPI

Elizabeth Daly Hicks, MD

  • Pediatrics Physician
  • Durham, NC
National Provider Identifier
1710374608
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101264958 Issued in VA
Practice address
2301 Erwin Rd
Durham, NC 27705-4699
Phone
(919) 681-8111
NPI assigned
Apr 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101264958 VA Primary

Addresses

Primary practice location

2301 Erwin Rd
Durham, NC 27705-4699

Mailing address

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 681-8111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181004002567 VA Practitioner - Pediatric Medicine 8921312877 Reassigns benefits to 1 organization
I20231024000215 DC Practitioner - Pediatric Medicine 8921312877 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101264958VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DLP Twin County Physician Practices LLC Current Accepting new patients
DLP Twin County Physician Practices LLC CurrentSince Sep 4, 2018 Accepting new patients
Children's Hospital Pediatrics CurrentSince Sep 15, 2023 Accepting new patients
Children's Hospital Current Accepting new patients
DLP Twin County Physician Practices LLC Pediatrics CurrentSince Sep 4, 2018 Accepting new patients
Children's Hospital CurrentSince Sep 15, 2023 Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

606 E Stuart Dr
Galax, VA 24333
Phone (276) 236-8166

961 E Stuart Dr
Galax, VA 24333
Phone (276) 236-3931

Organizations & group practices 6

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": "1429401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1710374608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054699",
            "telephone_number": "919-681-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ERWIN RD",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277054699",
            "telephone_number": "919-681-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "ELIZABETH",
        "middle_name": "DALY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-19",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101264958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.