Marjorie Kai Wickenden, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

26699 Issued in MA

Practice address

414 Main St
Wakefield, MA 01880-3018

Phone

(781) 245-0055

Fax

(781) 245-8855

NPI assigned

Jun 19, 2023

Sex

Female

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

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Active Motion Physical TherapyGroup PAC ID 1052350394, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Active Motion Physical Therapy

  • Orthopedic Physical Therapist
  • Wakefield, MA
  • NPI 1306979604
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1447935382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 MAIN ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018803018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 MAIN ST",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "018803018",
            "telephone_number": "781-245-0055",
            "fax_number": "781-245-8855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKENDEN",
        "first_name": "MARJORIE",
        "middle_name": "KAI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-19",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "26699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Whitby
• George White, LMHC
• Jeffrey Neil White, LICSW, ACSW
• Kaitlin Elaine White, PSYD, MA, MED
• Kris A. Whitney, LICSW
• Nathan Wilcox, LICSW
• William J. Fiore, DMD, P.C.
• Karen Williams
• Tom Richard Williams
• Karen D. Willis, BS, PTA

• Physical Therapist in Wakefield, MA
• Providers in Wakefield, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.