Individual provider Active NPI

Arthur Sterling Ticknor, M.D.

  • Family Medicine Physician
  • Winchester, VA
National Provider Identifier
1104997774
Registry record updated Mar 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101262588 Issued in VA
Practice address
160 Merchant St Ste 100
Winchester, VA 22603-4772
Phone
(540) 536-5560
Fax
(540) 536-5561
NPI assigned
Nov 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101262588 VA Primary

Addresses

Primary practice location

160 Merchant St Ste 100
Winchester, VA 22603-4772

Mailing address

220 Campus Blvd Ste 100
Winchester, VA 22601-2888
Phone (540) 536-5100

Other identifiers 1

IdentifierTypeStateIssuer
1104997774MedicaidVA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aticknor312703@soc.inova.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20171028000390 VA Practitioner - Family Practice 0941269864 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Rochester School of Medicine and Dentistry, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Winchester Medical CenterGroup PAC ID 0244134021, 313 clinicians

Practice addresses (Care Compare)

160 Merchant St
Winchester, VA 22603-4772
Phone (540) 536-5560

Hospital & facility affiliations

  • Valley Health Home Health Home health agency, Winchester, VA, CCN 497058
  • Winchester Medical Center Hospital, Winchester, VA, CCN 490005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101262588VAMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Winchester Medical Center CurrentSince May 1, 2021 Accepting new patients
Valley Physician Enterprise Inc Family Medicine CurrentSince Aug 6, 2017 Accepting new patients
Valley Physician Enterprise, Inc Family Medicine Current Accepting new patients
Valley Physician Enterprise, Inc. CurrentSince Aug 6, 2017 Accepting new patients
Winchester Medical Center Family Medicine CurrentSince May 1, 2021 Accepting new patients
Winchester Medical Center Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Chenango Memorial Hospital, Inc. Family Medicine Past Accepting new patients

Locations

1000 N Shenandoah Ave
Front Royal, VA 22630
Phone (540) 636-0300

220 Campus Blvd
Ste 100
Winchester, VA 22601

160 Merchant St
#100
Winchester, VA 22603
Phone (540) 536-5400

611 E Jubal Early Dr
Winchester, VA 22601
Phone (540) 536-5500

1840 Amherst St
Winchester, VA 22601
Phone (540) 536-8700

1440 Amherst St
Winchester, VA 22601
Phone (540) 450-3339

Interoperability endpoints

  • FHIR API: https://epicproxy.et1320.epichosted.com/FHIRProxy/api/FHIR/R4
  • Direct secure messaging: aticknor312703@valleyhealth.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614988800000",
    "number": "1104997774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 CAMPUS BLVD STE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226012888",
            "telephone_number": "540-536-5100",
            "fax_number": "540-536-0235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 MERCHANT ST STE 100",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226034772",
            "telephone_number": "540-536-5560",
            "fax_number": "540-536-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TICKNOR",
        "first_name": "ARTHUR",
        "middle_name": "STERLING",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2021-03-06",
        "certification_date": "2021-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101262588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104997774",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aticknor312703@soc.inova.org",
            "affiliation": "N",
            "address_1": "160 Merchant St Ste 100",
            "city": "Winchester",
            "state": "VA",
            "country_code": "US",
            "postal_code": "226034772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Winchester, VA

Sources for this page

Verify at the official NPI Registry.