Individual provider Active NPI

Jayson D Wickard

  • Basic Emergency Medical Technician
  • Canton, OH
National Provider Identifier
1265786107
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Basic Emergency Medical TechnicianTaxonomy code 146N00000X
License
144148 Issued in OH
Practice address
2215 6TH St SW
Canton, OH 44706-1327
Phone
(866) 576-4118
Fax
(877) 847-7347
NPI assigned
Oct 30, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Basic Emergency Medical Technician 146N00000X 144148 OH Primary

Addresses

Primary practice location

2215 6TH St SW
Canton, OH 44706-1327

Mailing address

PO Box 6229
Columbus, OH 43206-0229
Phone (866) 576-4118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
144148OHMDBasic Emergency Medical Technician

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351555200000",
    "number": "1265786107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6229",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432060229",
            "telephone_number": "866-576-4118",
            "fax_number": "877-847-7347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2215 6TH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447061327",
            "telephone_number": "866-576-4118",
            "fax_number": "877-847-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKARD",
        "first_name": "JAYSON",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146N00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Basic",
            "state": "OH",
            "license": "144148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.