Kevin Douglas Wicks, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT9887 Issued in FL

Practice address

3568 Clark Rd
Sarasota, FL 34231-8408

Phone

(941) 924-8868

Fax

(941) 924-6670

NPI assigned

Nov 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1993

Medicare assignment

May accept Medicare assignment

Group practices

Wicks in-House Gulfcoast Therapy PLLCGroup PAC ID 8628513520, 3 clinicians

Gulfcoast Physical Therapy and Performance Center IncGroup PAC ID 3779576806, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Gulfcoast Physical Therapy and Performance Center Inc

  • Physical Therapist
  • Sarasota, FL
  • NPI 1982738431
  Medicare reassignment Care Compare group NPD Authorized official
• Wicks in-House Gulfcoast Therapy PLLC

  • Physical Therapy Clinic/Center
  • Sarasota, FL
  • NPI 1770330813

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1154496412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 OLD SUMMERWOOD BLVD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342322940",
            "telephone_number": "941-379-3343",
            "fax_number": "941-924-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3568 CLARK RD",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342318408",
            "telephone_number": "941-924-8868",
            "fax_number": "941-924-6670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKS",
        "first_name": "KEVIN",
        "middle_name": "DOUGLAS",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT9887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MY BCBS NUMBER",
            "identifier": "Y905Z",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Wholesome Lactation Care, LLC
• Wholistic Health Clinic, Inc
• Scott C Wickless, DO
• Heather Wicklund, NP
• Wicks in-House Gulfcoast Therapy PLLC
• Meghan K Wicks, P.T.
• Christopher Widell
• Cynthia Marie Widman, LMHC
• Brittany C Wierzba, PHD
• Wilhelmine Wiese-Rometsch, MD

• Physical Therapist in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2025; 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.