Charles M Wicks, M.D.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

49128 Issued in MA

Practice address

233 Lincoln Ave
Haverhill, MA 01830-6738

Phone

(978) 374-1010

Fax

(978) 556-0568

NPI assigned

Sep 28, 2006

Last updated

Jun 9, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lahey Clinic, Inc

  • Internal Medicine Physician
  • Peabody, MA
  • NPI 1063447316
  Medicare reassignment NPD
• Lahey Clinic, Inc.

  dba Lahey Clinic

  • Internal Medicine Physician
  • Burlington, MA
  • NPI 1538194980
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Watertown, MA
  • NPI 1629398219
  Medicare reassignment NPD
• Steward Medical Group, Inc

  • Specialist
  • Brighton, MA
  • NPI 1356654495
  NPD

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1295827327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LAHEY CLINIC",
            "address_2": "41 MALL ROAD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "978-374-1010",
            "fax_number": "978-556-0568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 LINCOLN AVE",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306738",
            "telephone_number": "978-374-1010",
            "fax_number": "978-556-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKS",
        "first_name": "CHARLES",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "49128",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "49128",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0161772",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melisa J. Whithed, M.S
• Pamela Jean Whitlock
• Whittier Medical Associates
• Whittier Pavilion Inpatient Specialists PLLC
• Whittier Regional Vocational Technical High School District
• Carl J. Wighardt, M.S.P.T.
• Melody J Wilder, R.N.
• William T Benson DMD PC
• Tracy Jeannine Williams-Distefano
• Sean A Wilson

• Pulmonary Disease Physician in Haverhill, MA
• Providers in Haverhill, MA by specialty
• Pulmonary Disease Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.