Gary Wikert MD PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

34776 Issued in TN

Legal business name

GARY WIKERT MD PLLC

Practice address

29 Taylor Ave
Suite 210
Crossville, TN 38555-4527

Phone

(931) 707-5313

NPI assigned

Aug 3, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Gale Ann Wikert

Title

Office Manager

Phone

(931) 707-5313

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349222400000",
    "number": "1760490064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 TAYLOR AVE",
            "address_2": "SUITE 210",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554527",
            "telephone_number": "931-707-5313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 TAYLOR AVE",
            "address_2": "SUITE 210",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554527",
            "telephone_number": "931-707-5313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARY WIKERT MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2012-10-03",
        "status": "A",
        "authorized_official_last_name": "WIKERT",
        "authorized_official_first_name": "GALE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "931-707-5313",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TN",
            "license": "34776",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "D31365",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3735040",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "POO906801",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenna Joan Friend, AU.D.
• Adam Fusco, D.M.D.
• Michael Stewart Galloway, M.D.
• Beverly Joan Gardner, PA-C
• Amanda Michelle Garman, M.D.
• Honey Geer
• Genoa Healthcare LLC
• Elmer Rickey Gibbs, M.D.
• Joanna Cher Gibbs, MD
• Global Therapies PLLC

• Specialist in Crossville, TN
• Providers in Crossville, TN by specialty
• Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; 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.