Danielle Germain Wicklow, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

70820 Issued in AZ

Practice address

1111 E McDowell Rd
Dept. of Internal Medicine- Connie Farrington
Phoenix, AZ 85006-2612

Phone

(602) 239-2296

NPI assigned

Jun 21, 2008

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 17, 2025 through Jan 17, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1214006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315785600000",
    "number": "1790946853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "address_2": "DEPT. OF INTERNAL MEDICINE- CONNIE FARRINGTON",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 E MCDOWELL RD",
            "address_2": "DEPT. OF INTERNAL MEDICINE- CONNIE FARRINGTON",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062612",
            "telephone_number": "602-239-2296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKLOW",
        "first_name": "DANIELLE",
        "middle_name": "GERMAIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-21",
        "last_updated": "2011-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "70820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Gordon Wick II, D.C.
• Elden Wick
• Bree'Anna Wickey, DPT
• Morgan Wickey, MD
• Jessica Wickland, M.D.
• Steven W Wicklund
• Debra S Wickman, MD
• Skylar Ann Wickman
• Laura Wicks, PHARMD
• Victoria Wicus, MOT OTR/L, BCP, CIMI

• Internal Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Internal Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2011; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.