Kevin W. Hicks, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

T02874 Issued in MO

Practice address

131 Eureka Towne Center Dr
Eureka, MO 63025-1031

Phone

(636) 587-9775

Fax

(636) 587-9796

NPI assigned

Feb 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wal-Mart Stores East, LP

  • Optician
  • Eureka, MO
  • NPI 1780767061
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214524800000",
    "number": "1821060419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 EUREKA TOWNE CENTER DR",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251031",
            "telephone_number": "636-587-9775",
            "fax_number": "636-587-9796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 EUREKA TOWNE CENTER DR",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251031",
            "telephone_number": "636-587-9775",
            "fax_number": "636-587-9796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "KEVIN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-07",
        "last_updated": "2008-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gisoo Hashemi, RPH
• Healthcare Pharmacy Inc
• Heather R Hill MD LLC
• Sharon Henderson
• Herzog Crawford and Flynn, LLC
• Allison Hill
• Margaret Holtzmann, RD
• Lauren Stockwell Huckstep, DPT
• Carmen V Ihrig
• Russell Todd Imboden, D.O.

• Optometrist in Eureka, MO
• Providers in Eureka, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.