Andrew D. Bickham, IDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

License

T69-52-2586 Issued in VA

Practice address

159 Trout Avenue
Groton, CT 06340

Phone

(860) 694-2876

NPI assigned

Apr 7, 2010

Last updated

Apr 7, 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270598400000",
    "number": "1396061933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CORMORANT RD",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063403110",
            "telephone_number": "703-258-9239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 TROUT AVENUE",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "06340",
            "telephone_number": "860-694-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BICKHAM",
        "first_name": "ANDREW",
        "middle_name": "D.",
        "name_prefix": "Mr.",
        "credential": "IDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-07",
        "last_updated": "2010-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": "VA",
            "license": "T69-52-2586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Independent Duty Corpsman in Groton, CT
• Providers in Groton, CT by specialty
• Independent Duty Corpsman in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2010; 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.