DR. WICKIZER
NPI 1710408117
Clinic/Center - Multi-Specialty in Midlothian, VA
About Dr. Wickizer NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. WICKIZER (NPI 1710408117) is a healthcare organization registered as a multi-specialty in Midlothian, Virginia and active in the NPI registry since July 2017. The organization lists Boyd R Wickizer, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Wickizer is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Dr. Wickizer, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Boyd R Wickizer MD LLC's NPI number?
The NPI number for Boyd R Wickizer MD LLC is 1710408117. It was assigned to this organization in the NPPES registry on July 6, 2017. The provider is doing business as Dr. Wickizer.
Where is Boyd R Wickizer MD LLC located?
Boyd R Wickizer MD LLC is located at 2802 Otterdale Rd, Midlothian, VA 23112. The listed phone number is (804) 938-0264.
What is Boyd R Wickizer MD LLC's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.
Is Boyd R Wickizer MD LLC enrolled in Medicare?
Yes. Boyd R Wickizer MD LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Boyd R Wickizer MD LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Emergency Medicine) reassigns their Medicare billing to Boyd R Wickizer MD LLC. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Boyd R Wickizer MD LLC was last updated on July 6, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.
# Dr. Wickizer · NPI 1710408117
Multi-Specialty organization in Midlothian, Virginia. Organization record, active in the CMS NPPES registry since July 6, 2017.
## Identity
- **NPI:** 1710408117 (Entity type: Organization)
- **Enumerated:** July 6, 2017
- **Primary specialty:** Clinic/Center - Multi-Specialty · taxonomy 261QM1300X
- **Legal business name:** Boyd R Wickizer Md Llc
- **Organization subpart:** No
- **Authorized official:** Boyd Wickizer, PRESIDENT
## Practice location
- **Address:** 2802 OTTERDALE RD, Midlothian, VA 23112-5408
- **Phone:** (804) 938-0264
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Emergency Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 6, 2017
- **Other identifiers:** Medicaid 1750330353 (VA)
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Source: [NPI Profile](https://npiprofile.com/npi/1710408117) · Data from the CMS NPPES public registry.