DR. ANNELIES HICKERSON MD
NPI 1629469473
Surgery in Fort Campbell, KY
About Dr. Annelies Hickerson Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ANNELIES HICKERSON MD (NPI 1629469473) is an individual surgery provider in Fort Campbell, Kentucky, licensed in Virginia (0101262158) and active in the NPI registry since February 2015. She is enrolled in Medicare PECOS, is affiliated with Jennie Stuart Medical Center, and maintains a secondary practice location in Meridian.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Annelies Hickerson Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Annelies Hickerson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Mountain Home, ID 83647
- Reassigned Medicare billing, Idaho enrollment
- 1,312 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Jennie Stuart Medical Center
Acute Care Hospitals · Hopkinsville, KYPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 42223 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT CAMPBELL, KY 42223
FORT CAMPBELL, KY 42223
FORT CAMPBELL, KY 42223
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Annelies Hickerson's NPI number?
The NPI number for Annelies Hickerson is 1629469473. It was assigned to this individual provider in the NPPES registry on February 16, 2015.
Where is Annelies Hickerson located?
Annelies Hickerson practices at 650 Joel Dr, Fort Campbell, KY 42223. The listed phone number is (270) 412-6594.
What is Annelies Hickerson's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Annelies Hickerson enrolled in Medicare?
Yes. Annelies Hickerson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Annelies Hickerson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Annelies Hickerson reassigns Medicare benefits to St Lukes Clinic-Treasure Valley LLC (Mountain Home, ID). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Annelies Hickerson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Annelies Hickerson accept?
Health plans from Anthem Blue Cross and Blue Shield, Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and Select Health list Annelies Hickerson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Annelies Hickerson affiliated with any hospitals?
According to CMS data, Annelies Hickerson is affiliated with Jennie Stuart Medical Center.
When was this NPI record last updated?
The NPPES record for Annelies Hickerson was last updated on August 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dr. Annelies Hickerson, MD · NPI 1629469473
Surgery physician in Fort Campbell, Kentucky. Individual provider, active in the CMS NPPES registry since February 16, 2015.
## Identity
- **NPI:** 1629469473 (Entity type: Individual)
- **Enumerated:** February 16, 2015
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** 0101262158 (Virginia)
- **Sole proprietor:** No
## Practice location
- **Address:** 650 JOEL DR, Fort Campbell, KY 42223-5318
- **Phone:** (270) 412-6594
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** St Lukes Clinic-Treasure Valley LLC (NPI 1417297821, Mountain Home, ID), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2015
## Record status
- **NPPES last updated:** August 21, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1629469473) · Data from the CMS NPPES public registry.