Individual provider Active NPI

James L Wickham, ATC/L

  • Specialist
  • Chillicothe, OH
National Provider Identifier
1811908833
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
AT. 001518 Issued in OH
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

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

LicenseStateTypeSpecialty
AT. 001518OHMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Park Rehab, Inc. CurrentSince Apr 23, 2020 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.

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.

Verify at the official NPI Registry.