Individual provider Active NPI

Terry C Wicks, CRNA

  • Certified Registered Nurse Anesthetist
  • Hickory, NC
National Provider Identifier
1871697565
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
39206 Issued in NC
Practice address
810 Fairgrove Church Rd
Hickory, NC 28602-9617
Phone
(828) 326-3809
Fax
(828) 326-3371
NPI assigned
Sep 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 39206 NC Primary

Addresses

Primary practice location

810 Fairgrove Church Rd
Hickory, NC 28602-9617

Mailing address

111 Windsor Street
Rutherford College, NC 28672
Phone (828) 326-3809

Other identifiers 1

IdentifierTypeStateIssuer
8050983MedicaidNC

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Anesthesia Associates PA Nurse Anesthetist, Certified Registered CurrentSince Nov 28, 2020 Accepting new patients
Catawba Valley Medical Center CurrentSince Sep 8, 1998 Accepting new patients
Carolina Regional Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 28, 2020 Accepting new patients
Catawba Valley Medical Center Current Accepting new patients
Catawba Valley Medical Center CurrentSince Sep 8, 1998 Accepting new patients

Locations

3312 Battleground Ave
Greensboro, NC 27410
Phone (336) 282-5000

242A 9th Avenue Dr NE
Hickory, NC 28601
Phone (828) 327-6673

810 Fairgrove Church Rd
Hickory, NC 28602
Phone (704) 326-3000

1041 Morganton Blvd SW
#100
Lenoir, NC 28645
Phone (828) 323-2460

5115 Oleander Dr
Wilmington, NC 28403
Phone (910) 362-1011

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1871697565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WINDSOR STREET",
            "city": "RUTHERFORD COLLEGE",
            "state": "NC",
            "postal_code": "28672",
            "telephone_number": "828-326-3809",
            "fax_number": "828-326-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 FAIRGROVE CHURCH RD",
            "city": "HICKORY",
            "state": "NC",
            "postal_code": "286029617",
            "telephone_number": "828-326-3809",
            "fax_number": "828-326-3371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKS",
        "first_name": "TERRY",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "39206",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8050983",
            "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 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.