Active NPI
David Elvin Wickham, P.T.
- Physical Therapist
- Coshocton, OH
National Provider Identifier
1023223880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5994
- Practice address
- 353 Walnut St
Three Rivers Therapy Services
Coshocton, OH 43812-1531 - Phone
- (740) 295-7080
- Fax
- (740) 295-7081
- NPI assigned
- May 14, 2007
- Last updated
- Mar 17, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5994 | OH | Primary |
Addresses
Primary practice location
353 Walnut St
Three Rivers Therapy Services
Coshocton, OH 43812-1531
Mailing address
16330 TR 289
Conesville, OH 43811
Phone (740) 623-4069
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268784000000",
"number": "1023223880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16330 TR 289",
"city": "CONESVILLE",
"state": "OH",
"postal_code": "43811",
"telephone_number": "740-623-4069",
"fax_number": "740-623-4064"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "353 WALNUT ST",
"address_2": "THREE RIVERS THERAPY SERVICES",
"city": "COSHOCTON",
"state": "OH",
"postal_code": "438121531",
"telephone_number": "740-295-7080",
"fax_number": "740-295-7081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKHAM",
"first_name": "DAVID",
"middle_name": "ELVIN",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2010-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "5994",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coshocton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.