DR. KENNETH D. WICKER M.D. NPI 1992732994

NPI Information

NPI: 1992732994
Provider Name: DR. KENNETH D. WICKER, M.D.
Classification: Pediatrics - 2080P0204X
Entity Type: Individual

Specialization: Pediatric Emergency Medicine

PECOS Registration: Yes

Address:
2018 W CLINCH AVE
KNOXVILLE, TN
ZIP 37916
Phone: (865) 541-8000
Get Directions

DR. Kenneth D. Wicker, M.D. is a pediatric emergency medicine pediatrics in Knoxville, TN. The provider is a pediatrician who has special qualifications to manage emergencies in infants and children. DR. Kenneth D. Wicker, M.D. NPI is 1992732994. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2018 W CLINCH AVE
KNOXVILLE, TN
ZIP 37916-301
Phone: (865) 541-8000
Fax: (865) 539-8008

The NPI 1992732994 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/26/2006 and was last updated on 11/21/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207P00000X	Emergency Medicine		MD18702	TENNESSEE	No
2	208000000X	Pediatrics		MD18702	TENNESSEE	No
3	2080P0204X	Pediatrics	Pediatric Emergency Medicine	MD18702	TENNESSEE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	3082434	MEDICARE PIN	TENNESSEE
2	3055615	OTHER	TENNESSEE	BLUE CROSS
3	3082433	MEDICAID	TENNESSEE
4	3112589	OTHER	TENNESSEE	BLUE CROSS
5	4152062	OTHER	TENNESSEE	BLUE CROSS
6	3082434	MEDICAID	TENNESSEE
7	64928021	MEDICAID	KENTUCKY
8	F81004	MEDICARE UPIN	TENNESSEE
9	3082433	MEDICARE PIN	TENNESSEE
10	3082430	MEDICAID	TENNESSEE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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