DR. KENNETH D. WICKER M.D.
NPI 1992732994
Pediatrics - Pediatric Emergency Medicine in Knoxville, TN

Q: What is Kenneth Wicker's NPI number?

The NPI number for Kenneth Wicker is 1992732994. It was assigned to this individual provider in the NPPES registry on June 26, 2006.

Q: What is Kenneth Wicker's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Q: When was this NPI record last updated?

The NPPES record for Kenneth Wicker was last updated on November 21, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since June 26, 2006PECOS Enrolled

2018 W CLINCH AVE, KNOXVILLE, TN 37916(865) 541-8000(865) 539-8008 Get Directions Write a Review

NPPES record last updated: November 21, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Kenneth D. Wicker M.d. NPPES

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

DR. KENNETH D. WICKER M.D. (NPI 1992732994) is an individual pediatric emergency medicine provider in Knoxville, Tennessee, licensed in Tennessee (MD18702) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992732994

Entity TypeIndividualMale

Primary Taxonomy2080P0204X

Provider Legal NameDR. KENNETH D. WICKERCredential: M.D.

Location Address2018 W CLINCH AVEKnoxville, TN 37916-2301

Mailing AddressPo Box 634706Cincinnati, OH 45263-0001

Phone(865) 541-8000

Fax(865) 539-8008

Sole ProprietorNo

Enumeration DateJune 26, 2006

Last NPPES UpdateNovember 21, 2007

✔ NPI 1992732994 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0204X

License✔ Licensed in TN · MD18702

Definition

A pediatrician who has special qualifications to manage emergencies in infants and children.

Also ListedEmergency MedicineTaxonomy 207P00000X · License MD18702 (TN)

Also ListedPediatricsTaxonomy 208000000X · License MD18702 (TN)

2018 W CLINCH AVE, Knoxville, TN 37916

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Other Identifiers 10

Medicare PIN3082434TN

Other3055615TN · Blue Cross

Medicaid3082433TN

Other3112589TN · Blue Cross

Other4152062TN · Blue Cross

Medicaid3082434TN

Medicaid64928021KY

Medicare UPINF81004TN

Medicare PIN3082433TN

Medicaid3082430TN

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kenneth D. Wicker M.d. 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 20

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

DR. HEATHER DAWN PHILLIPS DO

Anesthesiology (Pediatric Anesthesiology)