Individual provider Active NPI

John Hicks, MD

  • Emergency Medicine Physician
  • Detroit, MI
National Provider Identifier
1962632679
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME113270 Issued in FL
Practice address
6071 W Outer Dr
Detroit, MI 48235-2624
Phone
(313) 966-1020
NPI assigned
Jul 16, 2009
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME113270 FL Primary

Addresses

Primary practice location

6071 W Outer Dr
Detroit, MI 48235-2624

Mailing address

100 Riverfront Dr Apt 1303
Detroit, MI 48226-4538
Phone (561) 379-5252

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20121004000479 FL Practitioner - Emergency Medicine 1658520721 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME113270FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Jul 14, 2023 Accepting new patients
Inphynet Contracting Services LLC Emergency Medicine CurrentSince Mar 10, 2018 Accepting new patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Jun 17, 2014 Accepting new patients
Sheridan Emergency Physician Services Inc Emergency Medicine CurrentSince Jan 14, 2015 Accepting new patients
Sheridan Emergency Physician Services Inc Emergency Medicine CurrentSince Jan 14, 2015 Accepting new patients

Locations

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

1700 S 23rd St
Fort Pierce, FL 34950
Phone (772) 461-4000

1210 S Old Dixie Hwy
Jupiter, FL 33458
Phone (561) 743-5073

901 45th St
Mangonia Park, FL 33407
Phone (561) 844-6300

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

4600 SW 46th Ct
Ocala, FL 34474
Phone (352) 291-3000

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

1613 NW 136th Ave
Ste 200
Sunrise, FL 33323
Phone (954) 838-2502

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

3360 Burns Rd
West Palm Beach, FL 33410
Phone (561) 622-1411

Interoperability endpoints

  • Direct secure messaging: jhicks20035@jupitermedicalcenter.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1247702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1962632679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RIVERFRONT DR APT 1303",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482264538",
            "telephone_number": "561-379-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6071 W OUTER DR",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482352624",
            "telephone_number": "313-966-1020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HICKS",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-16",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME113270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.