DR. ANNELIES HICKERSON MD
NPI 1629469473
Surgery in Fort Campbell, KY

Q: 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.

Q: What is Annelies Hickerson's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Active since February 16, 2015PECOS EnrolledAccepts Medicare Assignment

650 JOEL DR, FORT CAMPBELL, KY 42223(270) 412-6594 Get Directions Write a Review

NPPES record last updated: August 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 15, 2022, Nov 20, 2017 (2 updates tracked since 2017).

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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, maintains a secondary practice location in Meridian, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1629469473

Entity TypeIndividualFemale

Primary Taxonomy208600000X

Provider Legal NameDR. ANNELIES HICKERSONCredential: MD

Location Address650 JOEL DRFort Campbell, KY 42223-5318

Mailing Address3551 Roger Brooke Drive, Mche/meJbsa Fort Sam Houston, TX 78234 · (210) 916-6554

Phone(270) 412-6594

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateFebruary 16, 2015

Last NPPES UpdateAugust 21, 20252 updates tracked since enumeration

NPPES CertifiedAugust 21, 2025

✔ NPI 1629469473 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Licenses✔ Licensed in VA · 0101262158✔ Licensed in ID · 5771767

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

650 JOEL DR, Fort Campbell, KY 42223

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Secondary Practice Location 1

Location 1520 S Eagle Rd Ste 1241Meridian, ID 83642-6355 · Phone (208) 381-6930 · Fax (208) 381-6931

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

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.

PECOS PAC ID4981057874

PECOS Enrollment IDI20250905002451

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician 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.

New Patient

$82.24 typical visit price

range $52.76 – $162.27

Typical copayment $20.56 (range $13.19 – $40.56)

Most-billed visit code 99203

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

LISA RENEE CORDELL RN

Registered Nurse