Kari Wicklund, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA09171 Issued in TX

Practice address

1250 8TH Ave Ste 265
Fort Worth, TX 76104-4124

Phone

(682) 200-8580

Fax

(682) 200-8581

NPI assigned

May 16, 2014

Last updated

Sep 14, 2021By the provider in NPPES

Sex

Female

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 TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment
• Plastic Surgery Associates PA

  • Plastic and Reconstructive Surgery Physician
  • Fort Worth, TX
  • NPI 1588918551
  Medicare reassignment
• Healthtexas Provider Network

  dba Symmetry Anesthesia

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  dba One Medical with Baylor Scott & White Health

  • Family Medicine Physician
  • Fort Worth, TX
  • NPI 1992429161
  NPD

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1790196392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044110",
            "telephone_number": "817-922-4650",
            "fax_number": "817-922-4655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 8TH AVE STE 265",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044124",
            "telephone_number": "682-200-8580",
            "fax_number": "682-200-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKLUND",
        "first_name": "KARI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-16",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA09171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wholistic Midwifery
• Maximillian Whooley, MD
• Amanda Kay Whorton, RT (R)(CT)
• Katherine Wickersham
• Clarissa Wicklund, LMFT
• Angela K Wickstrum, PA-C
• Josef Widerhorn, M.D.
• Elizabeth Suzanne Widmer, P.A.-C
• Lisa Widmer, OTR
• April Rose Wiechmann, PHD

• Physician Assistant in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.