Active NPI
Larry W. Hicks, OD
- Optometrist
- Creston, IA
National Provider Identifier
1801905302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 01473
- Practice address
- 900 N Sumner Ave
Creston, IA 50801-1351 - Phone
- (641) 782-5970
- Fax
- (641) 782-2756
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 01473 | IA | Primary |
Addresses
Primary practice location
900 N Sumner Ave
Creston, IA 50801-1351
Mailing address
900 N Sumner Ave
Creston, IA 50801-1351
Phone (641) 782-5970
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0050625 | Medicaid | IA |
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264982400000",
"number": "1801905302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 N SUMNER AVE",
"city": "CRESTON",
"state": "IA",
"postal_code": "508011351",
"telephone_number": "641-782-5970",
"fax_number": "641-782-2756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 N SUMNER AVE",
"city": "CRESTON",
"state": "IA",
"postal_code": "508011351",
"telephone_number": "641-782-5970",
"fax_number": "641-782-2756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "LARRY",
"middle_name": "W.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2010-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IA",
"license": "01473",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0050625",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Creston, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 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.