Active NPI
Matthew Ray Hitchcock, M.D.
- Family Medicine Physician
- Hixson, TN
National Provider Identifier
1760645113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 52361
- Practice address
- 5104 Hixson Pike
Hixson, TN 37343-3932 - Phone
- (423) 763-1942
- Fax
- (423) 763-1842
- NPI assigned
- Jul 7, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 25411 | NE | |
| Family Medicine Physician | 207Q00000X | 52361 | TN | Primary |
Addresses
Primary practice location
5104 Hixson Pike
Hixson, TN 37343-3932
Mailing address
5104 Hixson Pike
Hixson, TN 37343-3932
Phone (423) 763-1942
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 4, 2018 through Apr 4, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25411 | NE | MD | Family Medicine Physician |
| 52361 | TN | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hitchcock Family Medicine, PLLC | Family Medicine | 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.
-
- Family Medicine Physician
- Hixson, TN
- NPI 1356936595
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721952000000",
"number": "1760645113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5104 HIXSON PIKE",
"city": "HIXSON",
"state": "TN",
"postal_code": "373433932",
"telephone_number": "423-763-1942",
"fax_number": "423-763-1842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5104 HIXSON PIKE",
"city": "HIXSON",
"state": "TN",
"postal_code": "373433932",
"telephone_number": "423-763-1942",
"fax_number": "423-763-1842"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HITCHCOCK",
"first_name": "MATTHEW",
"middle_name": "RAY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-07",
"last_updated": "2024-07-26",
"certification_date": "2024-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NE",
"license": "25411",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TN",
"license": "52361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hixson, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.