Individual Healthcare Provider
Amber Hicks-Thibodeau
Provider's NPPES record last updated: September 9, 2020
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1063869469
- Primary Specialty
- Family Medicine
- Practice Location
- Mooresville, North Carolina
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 9:35 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Family Medicine
Allopathic & Osteopathic Physicians
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Taxonomy code 207Q00000X
Provider-Reported License Information
- Family Medicine (North Carolina)
- 2015-02105
Practice Locations
Practice Location
798 Oak Ridge Farm Hwy. Suite A
Mooresville, North Carolina 28115
Phone: (704) 658-0011
Additional Practice Location
500 Gypsy Ln
Youngstown, Ohio 44504-1315
Phone: (330) 884-3235
Fax: (330) 884-3234
Additional Practice Location
5170 Belmont Ave
Youngstown, Ohio 44505-1022
Phone: (330) 759-2511
Fax: (330) 884-3234
Record Information
- Enumeration Date
- May 16, 2016
- Provider's NPPES Record Last Updated
- September 9, 2020
- Certification Date
- September 9, 2020
- NPISignal NPPES Dataset
- August 2026
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