Christopher Paul Hickie, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

31655 Issued in AZ

Practice address

10720 E Southern Ave
Suite 116
Mesa, AZ 85209-3810

Phone

(480) 365-0050

Fax

(480) 365-0049

NPI assigned

Oct 25, 2006

Last updated

Aug 19, 2021By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Gila River Health Care Corporation

  dba Komatke Health Center

  • Critical Access Hospital
  • Laveen, AZ
  • NPI 1376538231

  TX

  Medicare reassignment NPD
• Gila River Health Care

  dba Thwajik Ke Outpatient Behavioral Health Services

  • Community/Behavioral Health Agency
  • Laveen, AZ
  • NPI 1598021495
  NPD
• Gila River Health Care Corporation

  dba AK-Chin Clinic

  • Rural Acute Care Hospital
  • Maricopa, AZ
  • NPI 1386633915
  NPD
• Gila River Regional Behavioral Health Authority

  • Community/Behavioral Health Agency
  • Sacaton, AZ
  • NPI 1497880439
  NPD
• Northwest Hospital LLC

  dba Northwest Medical Center

  • Emergency Medicine Physician
  • Tucson, AZ
  • NPI 1477636108

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1851476386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 115",
            "city": "SACATON",
            "state": "AZ",
            "postal_code": "851470002",
            "telephone_number": "520-796-2600",
            "fax_number": "602-528-1296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10720 E SOUTHERN AVE",
            "address_2": "SUITE 116",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852093810",
            "telephone_number": "480-365-0050",
            "fax_number": "480-365-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKIE",
        "first_name": "CHRISTOPHER",
        "middle_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AZ",
            "license": "31655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE LICENSE",
            "identifier": "31655",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hi-Tech Home Care, Inc.
• James A Hiatt, M.D.
• Karl B Hiatt, MD
• Leah Hibbad
• Lilli Hibbs
• Colin Hicks
• Leonard Joseph Hicks, L.AC.
• Lowell Hicks
• Madison Hicks
• Sherri Hicks, LCSW

• Pediatrics Physician in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Pediatrics Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.