Jerry Wickman, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2414 Issued in WA

Practice address

774 Mullis St Ste a
Friday Harbor, WA 98250-7984

Phone

(360) 370-5500

Fax

(360) 370-5514

NPI assigned

Jan 4, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Aurora Community Health PLLC

  • Family Nurse Practitioner
  • Friday Harbor, WA
  • NPI 1821867961
  NPD (past)
• Friday Harbor Family Clinic PLLC

  • Clinic/Center
  • Friday Harbor, WA
  • NPI 1861143398
  NPD (past)

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063569770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 475",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "982500475",
            "telephone_number": "360-370-5500",
            "fax_number": "360-370-5514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 MULLIS ST STE A",
            "city": "FRIDAY HARBOR",
            "state": "WA",
            "postal_code": "982507984",
            "telephone_number": "360-370-5500",
            "fax_number": "360-370-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKMAN",
        "first_name": "JERRY",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "2414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Waters, LCSW, LMFT, LADC
• Bonita Wegenast, LMP
• Inge M. Wendelberger, M.A., CDPT
• Sarah Elizabeth Werling, MSW, LICSW
• Melissa Marie Wickey, LMT, EAMP
• Robert Dean Williams, MD
• Maia Yip, LMP
• Amara K Zee

• Chiropractor in Friday Harbor, WA
• Providers in Friday Harbor, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.