Eric Lynn Wickard, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

60230 Issued in OR

Practice address

965 Ellendale Dr
Medford, OR 97504-8215

Phone

(541) 734-3530

Fax

(253) 848-8567

NPI assigned

Oct 19, 2012

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)

Enrolled

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.

• Providence Health & Services - Oregon

  • Clinic/Center
  • Medford, OR
  • NPI 1093976243
  NPD

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1730432378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "541-734-3530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "965 ELLENDALE DR",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048215",
            "telephone_number": "541-734-3530",
            "fax_number": "253-848-8567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKARD",
        "first_name": "ERIC",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-19",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "60230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth White, PHARM.D., BCPS, RPH
• Audrey Whitford
• Emma Hailey Whitmarsh, CHW
• Carina Whittemore
• Wholeheartandmind LLC
• Teresa L. Wiczynski, PA
• Jeffrey G Wiencek, MD
• Brittney Wikoff
• Scott Wilber, MD
• John Wilcox

• Physical Therapist in Medford, OR
• Providers in Medford, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; 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.