NPIMap

Organization Active NPI

Brian S Hissom and Associates PLLC

  • Specialist
  • Hickory, NC
National Provider Identifier
1801977194
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
BRIAN S HISSOM AND ASSOCIATES PLLC
Practice address
321 7TH St NE Ste B
Hickory, NC 28601-5113
Phone
(828) 485-2195
Fax
(828) 485-2197
NPI assigned
Oct 17, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. Brian S Hissom, MA, LPC, NCCNPI 1770683385
Title
Owner
Phone
(828) 485-2195

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X NC Primary

Addresses

Primary practice location

321 7TH St NE Ste B
Hickory, NC 28601-5113

Mailing address

321 7TH St NE Ste B
Hickory, NC 28601-5113
Phone (828) 485-2195

Other identifiers 1

IdentifierTypeStateIssuer
6005884MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140929002286 NC Part B Supplier - Clinic/Group Practice 6103087143 Receives reassigned benefits from 5 practitioners
Practice locations: Hickory, NC; Morganton, NC

National Provider Directory

National Provider Directory
Tax ID family
Katelyn Harwood2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

205 E Union St
Morganton, NC 28655
Phone (828) 403-0421

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1801977194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 7TH ST NE STE B",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015113",
            "telephone_number": "828-485-2195",
            "fax_number": "828-485-2197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 7TH ST NE STE B",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286015113",
            "telephone_number": "828-485-2195",
            "fax_number": "828-485-2197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN S HISSOM AND ASSOCIATES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "HISSOM",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "828-485-2195",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, LPC, NCC"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005884",
            "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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.