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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: October 18, 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
Phone(864) 656-3076
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
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Secondary Practice Location 1

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

Other Identifiers 3

Medicaid000925306AGA
Medicaid002419SC
Medicaid89066G1NC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

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.

Medicare Billing Reassignments

3

Medicare enrollment records show Thomas Kickham reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Clemson University
Same address
Family
200 BOOKER DR
Walhalla, SC 29691
  • Reassigned Medicare billing, South Carolina enrollment
  • 17 clinicians in this Medicare group
NPI 1093990707 (864) 656-1969
Anmed Health
29 mi
Emergency Medicine
2000 E GREENVILLE ST
Anderson, SC 29621
  • Reassigned Medicare billing, South Carolina enrollment
  • 269 clinicians in this Medicare group
NPI 1588685333 (864) 512-1000
South Carolina Dept Of Mental Health Accounting Office
35 mi
Psychiatric Hospital
130 HIGHWAY 252
Anderson, SC 29621
  • Reassigned Medicare billing, South Carolina enrollment
  • 133 clinicians in this Medicare group
NPI 1376595041 (803) 898-8405

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

CLEMSON UNIVERSITY
Nurse Practitioner (Family)
200 BOOKER DR
WALHALLA, SC 29691
Oconee County (864) 656-1969
MS. CHRISTINA DIANE SMITH FNP
Nurse Practitioner (Family)
200 BOOKER DR
WALHALLA, SC 29691
Oconee County (864) 656-3076
CLEMSON UNIVERSITY
Clinic/Center (Rural Health)
200 BOOKER DR
WALHALLA, SC 29691
Oconee County (864) 656-3076
JACQUELINE GABRIELLE WILES APRN, FNP-BC
Nurse Practitioner (Family)
200 BOOKER DR
WALHALLA, SC 29691
Oconee County (864) 656-3076
MICHELLE MARIE DEEM FNP
Nurse Practitioner (Family)
200 BOOKER DR
WALHALLA, SC 29691
Oconee County (864) 656-3076
TIMOTHY AARON ZELLER MD
Family Medicine
200 BOOKER DR
WALHALLA, SC 29691
Oconee County (864) 656-3076
BROOKE ALLISON BRITTAIN MS, RD, LD, CHES
Dietitian, Registered
200 BOOKER DR
WALHALLA, SC 29691
Oconee County (864) 638-4279
ABIGAIL P MORNINGSTAR RD
Dietitian, Registered
200 BOOKER DR
WALHALLA, SC 29691
Oconee County (864) 656-3076

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.

Which organizations bill Medicare for Thomas Kickham's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Kickham reassigns Medicare benefits to 3 organizations: Clemson University (Walhalla, SC), Anmed Health (Anderson, SC) and South Carolina Dept Of Mental Health Accounting Office (Anderson, SC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thomas Kickham's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Thomas Kickham was last updated on December 13, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.