Zachary Seth Wickline, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DR.0072289 Issued in CO

Practice address

1890 N Revere CT Ste 4100
Aurora, CO 80045-7464

Phone

(303) 724-6021

Fax

(720) 724-4963

NPI assigned

Mar 23, 2020

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

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1584921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723939200000",
    "number": "1538795448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 N REVERE CT STE 4100",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457464",
            "telephone_number": "303-724-6021",
            "fax_number": "720-724-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 N REVERE CT STE 4100",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800457464",
            "telephone_number": "303-724-6021",
            "fax_number": "720-724-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKLINE",
        "first_name": "ZACHARY",
        "middle_name": "SETH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-23",
        "last_updated": "2024-08-18",
        "certification_date": "2024-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0072289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christiana Whyte, OTR/L
• James Eugene Wick, MD
• Kurt Wick, L.AC.
• Victoria Wickenheisser, MD
• Erin Corinne Wickham, LPN
• Stephen John Wicks, PHD
• Molly Wickstrom, LCSW
• Melissa Widener, PA-C
• Elise Widman
• Kaitlin Murphy Widmer, MD

• Psychiatry Physician in Aurora, CO
• Providers in Aurora, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.