Active NPI
James L Wickham, ATC/L
- Specialist
- Chillicothe, OH
National Provider Identifier
1811908833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- AT. 001518
- Practice address
- 4453 State Route 159
Chillicothe, OH 45601-8620 - Phone
- (740) 775-7722
- Fax
- (740) 775-7732
- NPI assigned
- Aug 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | AT. 001518 | OH | Primary |
Addresses
Primary practice location
4453 State Route 159
Chillicothe, OH 45601-8620
Mailing address
561 Jameson St
Ashville, OH 43103-2511
Phone (740) 775-7722
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AT. 001518 | OH | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Park Rehab, Inc. | Current | Accepting new patients | |
| Midwest Sports Therapy | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Geriatric Physical Therapist
- Etna, OH
- NPI 1790981033
-
- Physical Therapy Clinic/Center
- Chillicothe, OH
- NPI 1982721171
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1811908833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "561 JAMESON ST",
"city": "ASHVILLE",
"state": "OH",
"postal_code": "431032511",
"telephone_number": "740-775-7722",
"fax_number": "740-775-7732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4453 STATE ROUTE 159",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456018620",
"telephone_number": "740-775-7722",
"fax_number": "740-775-7732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WICKHAM",
"first_name": "JAMES",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "ATC/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "AT. 001518",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chillicothe, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.