Thomas A. Wicks, D.C.

Primary specialty

Orthopedic ChiropractorTaxonomy code 111NX0800X

License

A5695 Issued in IA

Practice address

1000 Brady St
Davenport, IA 52803-5214

Phone

(563) 884-5825

NPI assigned

Jul 28, 2005

Reactivated

Mar 27, 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 names 1

• Dr. Tom Wicks Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1346240736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 PRAIRIE VISTA CIR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527221828",
            "telephone_number": "563-359-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRADY ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528035214",
            "telephone_number": "563-884-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKS",
        "first_name": "THOMAS",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2014-03-18",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "IA",
            "license": "A5695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TOM",
            "last_name": "WICKS",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Lindsay K Wiese, RD. LD
• Rebecca Andresen Wiese, MD
• Matthew Theodore Wieskamp
• Angela R Willi, LISW

• Orthopedic Chiropractor in Davenport, IA
• Providers in Davenport, IA by specialty
• Orthopedic Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.