Kristin Wickham, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

52925 Issued in KY

Practice address

200 Clinic Dr
Madisonville, KY 42431-1661

Phone

(270) 825-7200

NPI assigned

Jun 22, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of Louisville School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Health Deaconess Medical Group IncGroup PAC ID 6103220330, 241 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Deaconess Health at Home Home health agency, Madisonville, KY, CCN 187013
• Centerwell Home Health Home health agency, Hopkinsville, KY, CCN 187124
• Caretenders Home health agency, Owensboro, KY, CCN 187178
• Baptist Health Deaconess Madisonville Hospital, Madisonville, KY, CCN 180093

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Baptist Health Deaconess Medical Group Inc

  • Internal Medicine Physician
  • Madisonville, KY
  • NPI 1437730942

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Baptist Health Medical Group Inc

  • Family Medicine Physician
  • Paducah, KY
  • NPI 1922401611
  Medicare reassignment NPD
• Baptist Health Deaconess Medical Group Inc

  • Hospitalist Physician
  • Madisonville, KY
  • NPI 1972320430

  Family Medicine

  NPD
• Baptist Health Medical Group Inc

  • Rural Health Clinic/Center
  • Dawson Springs, KY
  • NPI 1982178216
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Health Deaconess Madisonville Home Care, LLC

  • Home Health Agency
  • Madisonville, KY
  • NPI 1316723836
  Care Compare affiliation
• Baptist Health Deaconess Madisonville Inc

  • Rural Acute Care Hospital
  • Madisonville, KY
  • NPI 1447231956
  Care Compare affiliation
• Caretenders VS of Western Ky, LLC

  • Home Health Agency
  • Owensboro, KY
  • NPI 1588848238
  Care Compare affiliation
• Centerwell Certified Healthcare Corp.

  • Home Health Agency
  • Hopkinsville, KY
  • NPI 1518990258
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571097600000",
    "number": "1013368968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 STANLEY GAULT PARKWAY STE 129",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402255176",
            "telephone_number": "502-253-4900",
            "fax_number": "502-489-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 CLINIC DR",
            "city": "MADISONVILLE",
            "state": "KY",
            "postal_code": "424311661",
            "telephone_number": "270-825-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKHAM",
        "first_name": "KRISTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-22",
        "last_updated": "2019-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "11018785A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "52925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla Marie Wester, MSN, FNP
• Western Kentucky Technical Imaging, Inc
• Christopher K Whetstine
• Ashlenn Brei White
• Rachael White
• Wiggins Drugs Limited
• Andrea Renee Williams, DO
• Demetrica Williams
• Kelly King Williams
• Kevin Lee Williams, M.D.

• Family Medicine Physician in Madisonville, KY
• Providers in Madisonville, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.