CORY JOSEPH HICKS (NPI# 1588863450) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588863450 |
| Entity Type | Individual |
| Full Name | CORY JOSEPH HICKS |
| Credential | MD |
| Practice Address |
4901 Lang Ave Ne Albuquerque NM 87109-4495 |
| Mailing Address |
4273 Montgomery Blvd Ne Suite 200 E Albuquerque NM 87109-6748 |
| Practice Telephone | 5058428171 |
| Practice Fax Number | 5052460684 |
| Mailing Telephone | 5058215992 |
| Mailing Fax Number | 5058216692 |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2020-05-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | N7105 | TX | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | BP10027616 | TX | Allopathic & Osteopathic Physicians |
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
N7105 | TX | Allopathic & Osteopathic Physicians |
| Y | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
N7105 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 55236251 | 05 | |
| NM | MEDICAL LICENSE | MD2014-0172 | 01 |
| TX | MEDICAL LICENSE | N7105 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4273 Montgomery Blvd Ne, Suite 200 E, Albuquerque, NM 871096748 | 5058215992 | 5058216692 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265586119 | Cory L Hicks | Chiropractor | 1529 W Rogers Blvd, Suite C Lakeside Chiropractic Clinic, Skiatook, OK 74070 | 2007-01-22 |
| Street Address |
4901 LANG AVE NE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87109-4495 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114920238 | Douglas A. Clark | Internal Medicine | 4901 Lang Ave Ne, Albuquerque, NM 87109-4397 | 2005-05-23 |
| 1194387555 | Courtney Marquez | Physician Assistant | 4901 Lang Ave Ne, Albuquerque, NM 87109-4495 | 2019-07-05 |
| 1922570118 | Angerene Mitchell-matthews | Nurse Practitioner | 4901 Lang Ave Ne, Albuquerque, NM 87109-4495 | 2018-12-28 |
| 1700362597 | Sandra Lee Rowe | Nurse Practitioner | 4901 Lang Ave Ne, Albuquerque, NM 87109-4495 | 2018-07-14 |
| 1538612353 | Jennifer Vergeer | Nurse Practitioner | 4901 Lang Ave Ne, Albuquerque, NM 87109-4495 | 2016-07-28 |
| 1528418274 | Rachel S Camp | Physician Assistant | 4901 Lang Ave Ne, Suite 100, Albuquerque, NM 87109-4495 | 2016-06-14 |
| 1457707150 | Deborah Schwartz | Family Medicine | 4901 Lang Ave Ne, Albuquerque, NM 87109 | 2016-05-11 |
| 1407227002 | Truecare LLC | Family Medicine | 4901 Lang Ave Ne, Ste 202, Albuquerque, NM 87109-4495 | 2015-10-08 |
| 1174911093 | New Mexico Center for Minimally Invasive Therapies | Radiology | 4901 Lang Ave Ne, Suite 202, Albuquerque, NM 87109-4495 | 2014-12-30 |
| 1538566211 | Felicia R. Mazzei | Nurse Practitioner | 4901 Lang Ave Ne, Albuquerque, NM 87109 | 2014-11-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
| 1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
| 1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
| 1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
| 1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
| 1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
| 1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
| 1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
| 1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
| 1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
| Find all providers in zip 87109 | ||||
| Taxonomy Code | 207RP1001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Pulmonary Disease |
| An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427143601 | Richard H Seligman | Internal Medicine | 8300 Constitution Ne, Pmg Kaseman Sleep Lab/pulmonary, Albuquerque, NM 87110 | 2006-10-04 |
| 1679588131 | Gary Ken Iwamoto | Internal Medicine | 2211 Lomas Blvd. Ne, Unm Internal Medicine Clinic B, Albuquerque, NM 87106 | 2006-07-30 |
| 1043257520 | Miguel Pellerano | Internal Medicine | Pmg At 8300 Constitution - Pulmonary/critical Care, 8300 Constitution Ave Ne, Albuquerque, NM 87110 | 2006-06-01 |
| 1952373235 | Sivakumar Nagaraju | Internal Medicine | 500 Walter St Ne Ste 501, Albuquerque, NM 87102-2521 | 2006-02-02 |
| 1083602841 | Akshay Sood | Internal Medicine | 1101 Medical Arts Ave Ne Bldg 2, Unm Sleep Disorders Center, Albuquerque, NM 87102-2723 | 2005-10-06 |
| 1396150397 | Sara Assaf | Internal Medicine | 1 University of New Mexico # 105550, Albuquerque, NM 87131-0001 | 2014-06-27 |
| 1811245970 | Viral Girishchandra Gandhi | Internal Medicine | 500 Walter St Ne Ste 501, Albuquerque, NM 87102 | 2012-08-21 |
| 1295813202 | David Phillip Green | Internal Medicine | 3121 Amherst Dr Ne, Albuquerque, NM 87107-4807 | 2006-11-01 |
| 1205921384 | W. Gerald Brown | Internal Medicine | 1101 Medical Arts Ave Ne, Pmg Southwest Pulmonary Critical Care, Albuquerque, NM 87102-2706 | 2006-10-04 |
| 1689768053 | Ronald W Bronitsky | Internal Medicine | 1101 Medical Arts Ave Ne, Pmg Southwest Pulmonary Critical Care, Albuquerque, NM 87102-2706 | 2006-10-03 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87109 |
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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.