BENJAMIN MATTHEW HICKS (NPI# 1780687707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780687707 |
| Entity Type | Individual |
| Full Name | BENJAMIN MATTHEW HICKS |
| Other Name | B MATTHEW HICKS |
| Credential | M.D. |
| Practice Address |
7601 W Jefferson Blvd Fort Wayne IN 46804-4133 |
| Mailing Address |
Po Box 2526 Fort Wayne IN 46801-2526 |
| Practice Telephone | 2604368686 |
| Practice Fax Number | 2604368585 |
| Mailing Telephone | 2604368686 |
| Mailing Fax Number | 2604368585 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2016-11-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | 01046509A | IN | Allopathic & Osteopathic Physicians |
| Y | 207XX0801X |
Orthopaedic Surgery Specialization: Orthopaedic Trauma |
01046509A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ANTHEM | 00000089400 | 01 | |
| RAILROAD MEDICARE | 200032481 | 01 | |
| IN | 200089330A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396971727 | Benjamin Ferrill Hicks Jr. | Family Medicine | 1330 Crest Road, Del Mar, CA 92014-2529 | 2009-05-29 |
| 1891988481 | Benjamin Hicks | Internal Medicine | 4502 East 41st St, Tulsa, OK 74125-2512 | 2007-08-27 |
| 1740899335 | Benjamin David Hicks | Dentist | 6000 Us-98, Pensacola, FL 32512-0001 | 2020-07-29 |
| 1982149845 | Benjamin T Hicks | Physician Assistant | 715 N Weber St, Colorado Springs, CO 80903-1091 | 2017-01-03 |
| 1114315140 | Benjamin Hicks | Specialist/Technologist | 633 Emerson Rd, Suite 20, Creve Coeur, MO 63141-6739 | 2014-12-29 |
| 1184961963 | Benjamin L Hicks | Anesthesiologist Assistant | 417 W 3rd Ave, Albany, GA 31701-1943 | 2013-01-14 |
| 1124353099 | Benjamin J Hicks | Family Medicine | 827 S Jackson St, Osceola, IA 50213-1666 | 2009-10-12 |
| Street Address |
7601 W JEFFERSON BLVD |
| City | FORT WAYNE |
| State | IN |
| Zip Code | 46804-4133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497758429 | Fort Wayne Orthopaedics LLC | Orthopaedic Surgery | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2005-05-23 |
| 1801456553 | Elizabeth Schaefer | Specialist/Technologist | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2019-06-15 |
| 1417514480 | Courtney Mangan | Nurse Practitioner | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2019-05-24 |
| 1881177798 | Lindsey M. Hertenstein | Registered Nurse | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2018-09-07 |
| 1912407099 | Heather Korte | Registered Nurse | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2018-02-15 |
| 1902314958 | John Grimshaw | Registered Nurse | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2018-01-11 |
| 1053836882 | Alex Villavicencio | Nurse Practitioner | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2017-08-14 |
| 1841721735 | Abbey K. Bunnell | Nurse Practitioner | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2017-03-23 |
| 1093256950 | Jessica A. Wiedemann | Nurse Practitioner | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2017-03-13 |
| 1245786672 | Abigail Vanlaningham | Physician Assistant | 7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133 | 2016-08-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350344 | Derek Mumaw | Physical Therapist | 8420 Illinois Rd, Fort Wayne, IN 46804 | 2020-09-15 |
| 1942840228 | Erin M Mason | Behavior Technician | 5601 Coventry Ln, Fort Wayne, IN 46804 | 2020-01-14 |
| 1346880879 | Emily A Abdalla | Behavior Technician | 5601 Coventry Ln., Fort Wayne, IN 46804 | 2020-01-13 |
| 1083265433 | Fort Wayne Endodontics | Dentist | 9407 Illinois Rd, Fort Wayne, IN 46804 | 2019-09-26 |
| 1689140949 | Harrison Dental Group II, LLC | Dentist | 1333 Getz Rd, Fort Wayne, IN 46804 | 2018-10-15 |
| 1346731908 | Erin Nicole Zimmerman | Nurse Practitioner | 10170 Illinois Rd # 14, Fort Wayne, IN 46804 | 2018-05-19 |
| 1417446022 | Mary Harrington | Physical Therapist | 3320 Copper Hill Run, Fort Wayne, IN 46804 | 2018-05-09 |
| 1942701214 | Joshawa Todd Torres | Marriage & Family Therapist | 5651 Coventry Ln # 116, Fort Wayne, IN 46804 | 2018-02-22 |
| 1194235408 | Mitchell Kory Meyer | Specialist/Technologist | 9125 Yellow Tree Ct, Fort Wayne, IN 46804 | 2017-10-02 |
| 1902324916 | Emily Rene Sagstetter | Specialist/Technologist | 6034 Liberty Glade Ct, Fort Wayne, IN 46804 | 2017-08-30 |
| Find all providers in zip 46804 | ||||
| Taxonomy Code | 207XX0801X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Trauma |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821624461 | Michelle Nicole Hokl | Orthopaedic Surgery | 1801 N Senate Blvd Ste 535, Indianapolis, IN 46202-1204 | 2020-03-16 |
| 1265820914 | Adam Cota | Orthopaedic Surgery | 8450 Northwest Blvd, Indianapolis, IN 46278-1381 | 2015-01-05 |
| 1922308691 | John Anthony Mansour Jr. | Orthopaedic Surgery | 3736 S 4th St, Terre Haute, IN 47802-5507 | 2010-10-28 |
| 1972820421 | Roman M Natoli | Orthopaedic Surgery | 1801 N Senate Blvd, 535, Indianapolis, IN 46202-1228 | 2010-04-23 |
| 1770785032 | Patrick Joseph Laboe | Orthopaedic Surgery | 5255 E Stop 11 Rd, Indianapolis, IN 46237-6340 | 2007-05-31 |
| 1821103060 | Anthony T Sorkin | Orthopaedic Surgery | 1801 N Senate Blvd, Ste 536, Indianapolis, IN 46202-1228 | 2006-08-20 |
| City | FORT WAYNE |
| Zip Code | 46804 |
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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.