DR. DAVID C HICKS (NPI# 1104807924) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104807924 |
| Entity Type | Individual |
| Full Name | DR. DAVID C HICKS |
| Credential | M.D. |
| Practice Address |
3555 S National Ave Suite 100 Springfield MO 65807-7310 |
| Practice Telephone | 4178753800 |
| Practice Fax Number | 4178753176 |
| Mailing Telephone | 4178753800 |
| Mailing Fax Number | 4178753176 |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2012-08-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XX0004X |
Orthopaedic Surgery Specialization: Foot and Ankle Surgery |
2004009696 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | STATE LICENSE | 2004009696 | 01 |
| MO | 209273309 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700188984 | David Alan Hicks | Pharmacist | 613 Sixth, Sunnyside, WA 98944 | 2010-11-22 |
| 1881851590 | David D Hicks | Social Worker | 11 E State St, Marshalltown, IA 50158-4938 | 2008-05-20 |
| 1053513275 | David Hicks | Counselor | 1251 Jentes Rd, Wooster, OH 44691-7753 | 2007-06-01 |
| 1598818627 | David T Hicks | Optometrist | 313 N Division St, Harvard, IL 60033-3060 | 2007-01-20 |
| 1720070816 | David L Hicks | Family Medicine | 1000 S Rodney Parham Rd, Little Rock, AR 72204-2476 | 2005-08-16 |
| 1205354420 | David Timothy Hicks | Counselor | 207 Fairgrounds Rd, Hardinsburg, KY 40143-2585 | 2017-09-08 |
| 1235671512 | David Hicks Jr. | Student in an Organized Health Care Education/Training Program | 133 N River St, Wilkes Barre, PA 18711-0800 | 2016-11-17 |
| 1134674948 | David Alexander Hicks | Marriage & Family Therapist | 255 E Watt St, Alcoa, TN 37701-2236 | 2016-08-22 |
| 1467824383 | David Hicks | Dentist | 5918 Jonesboro Rd, Morrow, GA 30260-1103 | 2015-10-30 |
| 1538474317 | David Lawrence Hicks | Anesthesiology | 1850 Bluegrass Ave, Anesthesia Department, Louisville, KY 40215-1161 | 2010-08-17 |
| Street Address |
3555 S NATIONAL AVE SUITE 100 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65807-7310 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124009212 | Christopher M Miller | Orthopaedic Surgery | 3555 S National Ave, Springfield, MO 65807-7310 | 2005-11-07 |
| 1881218477 | Kristen Jean Cheever | Nurse Practitioner | 3555 S National Ave, Springfield, MO 65807-7310 | 2020-05-30 |
| 1124583968 | Christine J Palmer | Physician Assistant | 3555 S National Ave, Springfield, MO 65807-7310 | 2019-02-06 |
| 1114428547 | Jordan Phenicie | Physician Assistant | 3555 S National Ave, Springfield, MO 65807-7310 | 2018-02-21 |
| 1194224949 | Courtney Ray | Physician Assistant | 3555 S National Ave, Springfield, MO 65807-7310 | 2018-02-07 |
| 1427444686 | Jorden Tyler Komm | Emergency Medicine | 3555 S National Ave, Springfield, MO 65807-7310 | 2015-04-14 |
| 1386041739 | Chris Foster | Specialist/Technologist | 3555 S National Ave, Springfield, MO 65807-7310 | 2014-12-01 |
| 1568881407 | Connor Barnes | Surgery | 3555 S National Ave, Springfield, MO 65807-7310 | 2014-04-08 |
| 1982943502 | Joseph M Meystrik | Nurse Practitioner | 3555 S National Ave, Springfield, MO 65807-7310 | 2013-02-01 |
| 1326386863 | Erin Beth Clayman | Physician Assistant | 3555 S National Ave, Springfield, MO 65807-7310 | 2013-01-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396390241 | Karley Kassandra Murphy | Counselor | 3734 South Ave #c, Springfield, MO 65807 | 2019-08-07 |
| 1396203626 | Auvia L Logan | Dietitian, Registered | 3322 S. Campbell Ave. Suite Cc, Springfield, MO 65807 | 2019-03-05 |
| 1598250961 | Kathryn Barber | Nurse Practitioner | 3800 S National Ave Ste 700, Springfield, MO 65807 | 2018-06-27 |
| 1447764899 | Missouri Midwifery Service | Clinic/Center | 3840 South Avenue, Springfield, MO 65807 | 2017-11-21 |
| 1124530290 | Senior Living Management Group, LLC | Skilled Nursing Facility | 3705 S Jefferson Ave, Springfield, MO 65807 | 2017-10-30 |
| 1740663335 | Sarah E Kirk | Physical Therapist | 3545 S. National Ave, Springfield, MO 65807 | 2015-07-01 |
| 1750713335 | Amanda Ward | Nurse Practitioner | 2150 W Republic Rd Ste 112, Springfield, MO 65807 | 2013-08-06 |
| 1932531126 | Eugenia R Cortez | Counselor | 2124 Chesterfield Blvd., Springfield, MO 65807 | 2013-07-30 |
| 1962742866 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 3045 W Republic St, Springfield, MO 65807 | 2013-03-01 |
| 1033462387 | Miguel Angel Medina | Physician Assistant | 1900 South Sunshine Ave., Springfield, MO 65807 | 2012-10-24 |
| Find all providers in zip 65807 | ||||
| Taxonomy Code | 207XX0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Foot and Ankle Surgery |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, foot and ankle surgeons deal with adult reconstructive foot and ankle surgery, adult foot and ankle trauma, sports medicine foot and ankle, and children's foot and ankle reconstructive surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: title modified, definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. ACGME Accredited Residency Program Requirements: 1 year of training with 5 years Orthopedic Surgery for a total of 6 years. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235399924 | Craig Richard Lareau | Orthopaedic Surgery | 300 Birnie Ave, Ste 201, Springfield, MA 01107-1107 | 2008-06-16 |
| 1790824282 | Morton D Lynn | Orthopaedic Surgery | 300 Birnie Ave, Ste 201, Springfield, MA 01107-1107 | 2007-02-05 |
| 1639139868 | Thomas Aloysius Mcdonald | Orthopaedic Surgery | 300 Birnie Ave, Suite 201, Springfield, MA 01107-1107 | 2006-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528553880 | Rockhill Orthopaedic Specialists Inc | Orthopaedic Surgery | 600 Ne Adams Dairy Pkwy, Blue Springs, MO 64014-5496 | 2018-06-28 |
| 1205321569 | Rockhill Orthopaedic Specialists Inc | Orthopaedic Surgery | 120 Ne Saint Lukes Blvd Ste 200, Lees Summit, MO 64086-6011 | 2018-06-28 |
| 1710326467 | Megan Alexis Walters | Orthopaedic Surgery | 1755 S Grand Blvd, Saint Louis, MO 63104 | 2013-06-17 |
| 1598087652 | Gary J Schmidt Md LLC | Orthopaedic Surgery | 11605 Studt Ave, Suite One, Saint Louis, MO 63141-7052 | 2010-02-17 |
| 1043416985 | Nathan John Kiewiet | Orthopaedic Surgery | 2790 Clay Edwards Dr Ste 600, Kansas City, MO 64116-3274 | 2007-06-26 |
| 1265585111 | Jeremy James Mccormick | Orthopaedic Surgery | 4921 Parkview Pl, Ste 6a/6b/12a, Saint Louis, MO 63110-1032 | 2007-01-22 |
| 1619036878 | Sandra Elizabeth Klein | Orthopaedic Surgery | 4921 Parkview Pl, Ste 6a/6b/12a, Saint Louis, MO 63110-1032 | 2006-12-06 |
| 1912085358 | Saul Generoso Trevino | Orthopaedic Surgery | 1100 Virginia Ave, Columbia, MO 65212-0001 | 2006-11-02 |
| 1275551699 | Jeffrey E Johnson | Orthopaedic Surgery | 4921 Parkview Pl, Ste 6a/6b/12a, Saint Louis, MO 63110-1032 | 2006-07-17 |
| 1669417416 | James Winston Bogener | Orthopaedic Surgery | 2301 Holmes St, Department of Orthopaedic Surgery, Kansas City, MO 64108-2640 | 2006-06-17 |
| Find all providers with the same taxonomy | ||||
| City | SPRINGFIELD |
| Zip Code | 65807 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.