Kai Alexandria Wicker Brown, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD.203116 Issued in LA

Practice address

5716 Jackson St
Alexandria, LA 71303-2042

Phone

(318) 767-6503

Fax

(318) 703-8257

NPI assigned

May 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Kai Alexandra Wicker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Jackson Street Pediatrics, LLC

  • Pediatrics Physician
  • Alexandria, LA
  • NPI 1205454774
  NPD Authorized official

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627603200000",
    "number": "1457569063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5716 JACKSON ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032042",
            "telephone_number": "318-767-6503",
            "fax_number": "318-703-8257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5716 JACKSON ST",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032042",
            "telephone_number": "318-767-6503",
            "fax_number": "318-703-8257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKER BROWN",
        "first_name": "KAI",
        "middle_name": "ALEXANDRIA",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-18",
        "last_updated": "2021-07-30",
        "certification_date": "2021-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD.203116",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.203116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1808172",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAI",
            "last_name": "WICKER",
            "middle_name": "ALEXANDRA",
            "prefix": "MS.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tashiana Whitehead
• Chrishonda Marie Whitlock, PA-C
• Elizabeth Whitmore, RN
• Charles Rud Whittington, DC
• Sarah Ann Whittington, BSN, RN, CCRN
• Miriam J Wilbon, PA
• Wildel, LLC
• Wildel, LLC
• Wildel, LLC
• Jeremy Matthew Wiley, MSN, APRN, FNP-C

• Pediatrics Physician in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; 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.