Organization Active NPI

Hickory Surgical Clinic, Inc.

  • Surgery Physician
  • Hickory, NC
National Provider Identifier
1780647073
Registry record updated Apr 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
39117 Issued in NC
Legal business name
HICKORY SURGICAL CLINIC, INC.
Practice address
415 N Center St
Suite 102
Hickory, NC 28601-5036
Phone
(828) 327-9178
Fax
(828) 304-0202
NPI assigned
Apr 9, 2006
Last updated
Apr 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2010

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

Authorized official

Name
Mrs. Michele F Haynes
Title
Practice Administrator
Phone
(828) 327-9178

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 39117 NC Primary

Addresses

Primary practice location

415 N Center St
Suite 102
Hickory, NC 28601-5036

Mailing address

415 N Center St
Suite 102
Hickory, NC 28601-5036
Phone (828) 327-9178

Other identifiers 3

IdentifierTypeStateIssuer
01779OtherNCBLUE CROSS BLUE SHIELD NC
CD2324OtherNCRAIL ROAD MEDICARE
8901779MedicaidNC

National Provider Directory

National Provider Directory

Locations

415 N Center St
Ste 102
Hickory, NC 28601
Phone (704) 327-9178

706 Hartness Rd
Statesville, NC 28677
Phone (704) 871-2949

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1144540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1780647073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N CENTER ST",
            "address_2": "SUITE 102",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015036",
            "telephone_number": "828-327-9178",
            "fax_number": "828-304-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 N CENTER ST",
            "address_2": "SUITE 102",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015036",
            "telephone_number": "828-327-9178",
            "fax_number": "828-304-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HICKORY SURGICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-09",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "HAYNES",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "828-327-9178",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "39117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NC",
            "identifier": "01779",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "CD2324",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8901779",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hickory, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.