Active NPI
Thomas Kevin Hicks, M.D.
- Adult Medicine Physician
- Chicopee, MA
National Provider Identifier
1972677680
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- 58979
- Practice address
- 103 Johnson Rd
Chicopee, MA 01022-1063 - Phone
- (413) 593-4000
- Fax
- (423) 593-4097
- NPI assigned
- Nov 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Medicine Physician | 2083X0100X | 58979 | MA | |
| Adult Medicine Physician | 207QA0505X | 58979 | MA | Primary |
Addresses
Primary practice location
103 Johnson Rd
Chicopee, MA 01022-1063
Mailing address
22B Lee St
Marblehead, MA 01945-3215
Phone (508) 769-0718
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
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712016000000",
"number": "1972677680",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22B LEE ST",
"city": "MARBLEHEAD",
"state": "MA",
"postal_code": "019453215",
"telephone_number": "508-769-0718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 JOHNSON RD",
"city": "CHICOPEE",
"state": "MA",
"postal_code": "010221063",
"telephone_number": "413-593-4000",
"fax_number": "423-593-4097"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HICKS",
"first_name": "THOMAS",
"middle_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-17",
"last_updated": "2024-04-02",
"certification_date": "2024-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "2083X0100X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Occupational Medicine",
"state": "MA",
"license": "58979",
"primary": false
},
{
"code": "207QA0505X",
"taxonomy_group": "",
"desc": "Family Medicine, Adult Medicine",
"state": "MA",
"license": "58979",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicopee, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.