Active NPI
Kevin Hicks
- Private Vehicle
- Petersburg, VA
National Provider Identifier
1811530793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- T65434407
- Practice address
- 122 N Plains Dr
Petersburg, VA 23805-9110 - Phone
- (804) 647-3283
- NPI assigned
- Oct 23, 2019
- 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 |
|---|---|---|---|---|
| Private Vehicle | 347C00000X | T65434407 | VA | Primary |
Addresses
Primary practice location
122 N Plains Dr
Petersburg, VA 23805-9110
Mailing address
122 N Plains Dr
Petersburg, VA 23805-9110
Phone (804) 647-3283
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 |
|---|---|---|---|
| T65434407 | VA | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571788800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571788800000",
"number": "1811530793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 N PLAINS DR",
"city": "PETERSBURG",
"state": "VA",
"postal_code": "238059110",
"telephone_number": "804-647-3283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 N PLAINS DR",
"city": "PETERSBURG",
"state": "VA",
"postal_code": "238059110",
"telephone_number": "804-647-3283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "KEVIN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-23",
"last_updated": "2019-10-23",
"status": "A"
},
"taxonomies": [
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "VA",
"license": "T65434407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petersburg, VA
- Thomas James Hennessey, D.C.
- Here for You LLC (Here for You Home Health)
- HHC Poplar Springs Hospital Inc (Poplar Springs Hospital)
- HHC Poplar Springs LLC. (Poplar Springs Hospital)
- HHC Poplar Springs LLC. (Poplar Springs Hospital)
- Tyese Lorraine Hicks, RN
- Tyra Jameese Hicks, MA, QMHP
- Christie D Hill, PH.D.
- Reginald Maurice Hill
- Beulah Hines
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.