Kennedi Wickham

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

C0010599 Issued in MD

Practice address

12200 Annapolis Rd Ste 315
Glenn Dale, MD 20769-9182

Phone

(301) 249-0970

NPI assigned

Jun 30, 2026

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Valerie Callender M. D. PC

  • Specialist
  • Glenn Dale, MD
  • NPI 1275834202
  NPD (past)

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

{
    "created_epoch": "1782777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1225955545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13917 ROCKINGHAM RD",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208742230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 ANNAPOLIS RD STE 315",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699182",
            "telephone_number": "301-249-0970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKHAM",
        "first_name": "KENNEDI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-30",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MD",
            "license": "C0010599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Branick Ngombi Wangia
• Beth S Warner, PH.D.
• Patricia A. Warrick, LCSW-C
• R. White-Smith, M.ED
• Audrey Olivia White, DNP, FNP-C
• Mary Grace Legaspi Wild, MSN, RN, AGPCNP-BC
• Alexis Wilkerson
• Monica Nicole Williams
• Elisha Nicole Wilson
• Xpress Medical Specialties, LLC

• Dermatology Physician in Glenn Dale, MD
• Providers in Glenn Dale, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; 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.