Amelia Wickersham

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

Practice address

2670 Crimson Canyon Dr Ste 150
Las Vegas, NV 89128-0848

Phone

(702) 405-8044

NPI assigned

Oct 29, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1572307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1124662507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 S JONES BLVD STE 3648",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891072623",
            "telephone_number": "747-282-9696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 CRIMSON CANYON DR STE 150",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891280848",
            "telephone_number": "702-405-8044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKERSHAM",
        "first_name": "AMELIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-29",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "372500000X",
            "taxonomy_group": "",
            "desc": "Chore Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747A0650X",
            "taxonomy_group": "",
            "desc": "Technician, Attendant Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@hopepca-vegas.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "2670 Crimson Canyon Dr Ste 150",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891280848",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maria Wibowo
• Tannie Wichern, RBT
• David Ray Wichman, DO
• Jason Craig Wickens, MD
• Angela Dee Wicker
• Ryan Howard Wickes
• Barry D Wicklund
• Marissa Wicklund
• Shanika Roshanie Wickramarachchi
• Sienna Christine Wickramasekera, PA-C

• Personal Care Attendant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Personal Care Attendant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.