Active NPI
Samantha Hickey
- Physician Assistant
- Farmington Hills, MI
National Provider Identifier
1801308291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 5601008454
- Practice address
- 37935 W 12 Mile Rd
Farmington Hills, MI 48331-3035 - Phone
- (248) 987-4877
- NPI assigned
- Oct 25, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 5601008454 | MI | Primary |
Addresses
Primary practice location
37935 W 12 Mile Rd
Farmington Hills, MI 48331-3035
Mailing address
5120 Autumn Ridge CT
West Bloomfield, MI 48323-2700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5601008454 | MI | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673913600000",
"number": "1801308291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5120 AUTUMN RIDGE CT",
"city": "WEST BLOOMFIELD",
"state": "MI",
"postal_code": "483232700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "37935 W 12 MILE RD",
"city": "FARMINGTON HILLS",
"state": "MI",
"postal_code": "483313035",
"telephone_number": "248-987-4877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKEY",
"first_name": "SAMANTHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-25",
"last_updated": "2023-01-17",
"certification_date": "2023-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MI",
"license": "5601008454",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Farmington Hills, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.