Active NPI
Brian P Wicks, M.D.
- Orthopaedic Hand Surgery Physician
- Silverdale, WA
National Provider Identifier
1346286986
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Hand Surgery Physician
- License
- MD00027475
- Practice address
- 2200 NW Myhre Rd
Silverdale, WA 98383-7681 - Phone
- (360) 830-1100
- NPI assigned
- Jun 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | MD00027475 | WA | |
| Orthopaedic Hand Surgery Physician | 207XS0106X | MD00027475 | WA | Primary |
Addresses
Primary practice location
2200 NW Myhre Rd
Silverdale, WA 98383-7681
Mailing address
9621 Ridgetop Blvd NW
Silverdale, WA 98383-8502
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8937342 | Other | WA | CRIME VICTIMS COMP |
| 8117954 | Medicaid | WA | |
| 200007065 | Other | RAILROAD MEDICARE | |
| 4587297 | Other | AETNA | |
| WI9576 | Other | REGENCE BLUE SHIELD | |
| 75451 | Other | WA | LABOR & INDUSTRIES |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1346286986",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9621 RIDGETOP BLVD NW",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983838502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2200 NW MYHRE RD",
"city": "SILVERDALE",
"state": "WA",
"postal_code": "983837681",
"telephone_number": "360-830-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKS",
"first_name": "BRIAN",
"middle_name": "P",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "WA",
"license": "MD00027475",
"primary": false
},
{
"code": "207XS0106X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Hand Surgery",
"state": "WA",
"license": "MD00027475",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CRIME VICTIMS COMP",
"identifier": "8937342",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8117954",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "200007065",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4587297",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD",
"identifier": "WI9576",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRIES",
"identifier": "75451",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Silverdale, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.