NPIMap

Organization Active NPI

Michael D Wicks, MD PC

  • Family Medicine Physician
  • Silverton, OR
National Provider Identifier
1689607210
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD09070 Issued in OR
Legal business name
MICHAEL D WICKS, MD PC
Practice address
347 Fairview St
Silverton, OR 97381-1916
Phone
(503) 873-8341
Fax
(503) 873-2328
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Authorized official

Name
Dr. Michael David Wicks, M.D.NPI 1154346591
Title
Owner
Phone
(503) 873-8341

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X MD09070 OR Primary

Addresses

Primary practice location

347 Fairview St
Silverton, OR 97381-1916

Mailing address

347 Fairview St
Silverton, OR 97381-1916
Phone (503) 873-8341

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281916800000",
    "number": "1689607210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 FAIRVIEW ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973811916",
            "telephone_number": "503-873-8341",
            "fax_number": "503-873-2328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 FAIRVIEW ST",
            "city": "SILVERTON",
            "state": "OR",
            "postal_code": "973811916",
            "telephone_number": "503-873-8341",
            "fax_number": "503-873-2328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D WICKS, MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2010-08-16",
        "status": "A",
        "authorized_official_last_name": "WICKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-873-8341",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD09070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silverton, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.