HOLLY HICKS-DERIDDER PA-C NPI 1578641627

NPI Information

  • NPI: 1578641627
  • Provider Name: HOLLY HICKS-DERIDDER, PA-C
  • Classification: Physician Assistant - 363AM0700X
  • Specialization: Medical
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2700 HIGHWAY 34 E BLDG 300
    NEWNAN, GA
    ZIP 30265
  • Phone: (770) 304-0987

Map and Directions

Get Directions

NPI Details

Holly Hicks-deridder, PA-C is a medical physician assistant in Newnan, GA. Holly Hicks-deridder, PA-C NPI is 1578641627. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2700 HIGHWAY 34 E BLDG 300
NEWNAN, GA
ZIP 30265-330
Phone: (770) 304-0987
Fax: (770) 251-0938

The NPI 1578641627 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Hemoglobin a1c level (HCPCS:83036)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Administration of influenza virus vaccine (HCPCS:G0008)
  • Influenza vaccine split virus, preservative free (HCPCS:90662)
  • Urinalysis, manual test (HCPCS:81002)
  • Telephone medical discussion with physician, 11-20 minutes (HCPCS:99442)
  • Administration of pneumococcal vaccine (HCPCS:G0009)

The enumeration date for this NPI number is 11/2/2006 and was last updated on 11/1/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363AM0700XPhysician AssistantMedical003338GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
197WCCRBMEDICARE PINGEORGIA
2P56134MEDICARE UPINGEORGIA
3100002196AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI