THOMAS C. KICKHAM D.O.
NPI 1669434437
General Practice in Walhalla, SC

Active since April 05, 2006PECOS Enrolled
200 BOOKER DR, WALHALLA, SC 29691(864) 656-3076(843) 985-9562 Get Directions Write a Review

NPPES record last updated: December 13, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 13, 2023, Oct 21, 2022 (2 updates tracked since 2022).

About Thomas C. Kickham D.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THOMAS C. KICKHAM D.O. (NPI 1669434437) is an individual general practice provider in Walhalla, South Carolina, licensed in South Carolina (241) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Anderson.

NPPES Registry Identity

NPI1669434437
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameTHOMAS C. KICKHAMCredential: D.O.
Location Address200 BOOKER DRWalhalla, SC 29691-2278
Mailing Address800 N Fant StAnderson, SC 29621-5708 · (864) 512-1335 · Fax (843) 985-9562
Fax(843) 985-9562
Sole ProprietorNo
Enumeration DateApril 5, 2006
Last NPPES UpdateDecember 13, 20232 updates tracked since enumeration
NPPES CertifiedDecember 13, 2023
NPI 1669434437 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License Licensed in SC · 241
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedEmergency MedicineTaxonomy 207P00000X · License 241 (SC)
200 BOOKER DR, Walhalla, SC 29691

Secondary Practice Location 1

Location 1800 N Fant StAnderson, SC 29621-5708 · Phone (864) 512-1335

Other Identifiers 3

Medicaid000925306AGA
Medicaid002419SC
Medicaid89066G1NC

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Thomas C. Kickham D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
200 BOOKER DR
WALHALLA, SC 29691
Nurse Practitioner (Family)
200 BOOKER DR
WALHALLA, SC 29691
Clinic/Center (Rural Health)
200 BOOKER DR
WALHALLA, SC 29691
Nurse Practitioner (Family)
200 BOOKER DR
WALHALLA, SC 29691
Nurse Practitioner (Family)
200 BOOKER DR
WALHALLA, SC 29691
Family Medicine
200 BOOKER DR
WALHALLA, SC 29691
Dietitian, Registered
200 BOOKER DR
WALHALLA, SC 29691
Dietitian, Registered
200 BOOKER DR
WALHALLA, SC 29691

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thomas Kickham's NPI number?

The NPI number for Thomas Kickham is 1669434437. It was assigned to this individual provider in the NPPES registry on April 5, 2006.

Where is Thomas Kickham located?

Thomas Kickham practices at 200 Booker Dr, Walhalla, SC 29691. The listed phone number is (864) 656-3076.

What is Thomas Kickham's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Thomas Kickham enrolled in Medicare?

Yes. Thomas Kickham is registered in the Medicare PECOS enrollment system.

What insurance does Thomas Kickham accept?

Health plans from First Choice Next list Thomas Kickham as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thomas Kickham was last updated on December 13, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.