DR. ERIC D WICKS (NPI# 1184787228) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1184787228 |
Entity Type | Individual |
Full Name | DR. ERIC D WICKS |
Credential | M.D. |
Practice Address |
3030 Harden Blvd Lakeland FL 33803 |
Mailing Address |
1324 Lakeland Hills Blv.d Attn: Managed Care Dept. Lakeland FL 33805 |
Practice Telephone | 8636871250 |
Practice Fax Number | 8636871258 |
Enumeration Date | 2006-12-19 |
Last Update Date | 2020-07-15 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 111N00000X | Chiropractor | CH9310 | FL | Chiropractic Providers |
Y | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
ME118027 | FL | Allopathic & Osteopathic Physicians |
Address | Telephone Number | Fax Number |
---|---|---|
1324 Lakeland Hills Blvd, Lakeland, FL 338054543 | 8636871321 | 8636871258 |
1222 South Orange Avenue, Orthopaedics Fifth Floor Mp43, Orlando, FL 32806 | 3218411764 |
Street Address |
3030 HARDEN BLVD |
City | LAKELAND |
State | FL |
Zip Code | 33803 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558365197 | Patricia G Eseverri | Internal Medicine | 3030 Harden Blvd, Lakeland, FL 33803-7952 | 2005-06-10 |
1144789785 | Anielys Salgado | Nurse Practitioner | 3030 Harden Blvd, Lakeland, FL 33803-7952 | 2019-03-13 |
1801376249 | Alexandra Zambito Hopkins | Audiologist | 3030 Harden Blvd, Lakeland, FL 33803 | 2018-08-15 |
1235685512 | Ryan Payne | Specialist/Technologist | 3030 Harden Blvd, Bldg #2, Lakeland, FL 33803 | 2016-08-28 |
1326494634 | Keri Sawyer | Nurse Practitioner | 3030 Harden Blvd, Lakeland, FL 33803-7952 | 2016-05-05 |
1588026728 | Amanda Ratliff Dailey | Family Medicine | 3030 Harden Blvd, Lakeland, FL 33803-7952 | 2016-03-27 |
1598186801 | Jessica Eliza Campbell | Nurse Practitioner | 3030 Harden Blvd, Lakeland, FL 33803-7952 | 2014-01-04 |
1932549946 | Latoya Robinson | Nurse Practitioner | 3030 Harden Blvd, Lakeland, FL 33803-7952 | 2013-07-05 |
1669817144 | Lakeland Regional Health Systems, Inc. | Clinic/Center | 3030 Harden Blvd, Lakeland, FL 33803-7952 | 2013-05-09 |
1457604738 | Lindsey Ann Hahn | Obstetrics & Gynecology | 3030 Harden Blvd, Lakeland, FL 33803 | 2012-10-24 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861964819 | Steven P Agelidis | Counselor | 2020 S. Florida Ave, Suite 207, Lakeland, FL 33803 | 2018-12-31 |
1902316201 | Kesara Mai Ngam | Massage Therapist | 117 West Oak Drive, Lakeland, FL 33803 | 2017-10-02 |
1396260618 | Suncoast Behavioral Solutions, LLC | Behavioral Analyst | 1920 E Edgewood Dr Apt A8, Lakeland, FL 33803 | 2017-08-08 |
1316484413 | Daniel Jacob Stahl | Behavior Technician | 145 East Edgewood Drive, Lakeland, FL 33803 | 2017-01-26 |
1780037002 | Shelley Stettinius | Behavioral Analyst | 145 East Edgewood Dr, Lakeland, FL 33803 | 2016-07-21 |
1396106654 | Highlands Occupational Therapy, Inc | Occupational Therapist | 2000 East Edgewood Drive, Suite 114, Lakeland, FL 33803 | 2016-03-15 |
1003289570 | Jayna Dinsmore | Physical Therapy Assistant | 321 Imperial Blvd, D38, Lakeland, FL 33803 | 2015-11-05 |
1093187429 | Healthstat Wellness Polk-lakeland | Preventive Medicine | 3215 Winter Lake Road, Lakeland, FL 33803 | 2015-10-26 |
1962812545 | Florida Presbyterian Homes, Inc | Nursing Facility/Intermediate Care Facility | 901 Lakeside Avenue, Lakeland, FL 33803 | 2014-05-05 |
1710316336 | Trinity Endodontics | Health Maintenance Organization | 1602 S. Florida Ave, Ste #1, Lakeland, FL 33803 | 2013-11-04 |
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Taxonomy Code | 207XX0005X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Orthopaedic Surgery |
Specialization | Sports Medicine |
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023080892 | Phuc Vo | Orthopaedic Surgery | 1600 Lakeland Hills Blvd, Lakeland, FL 33805 | 2006-02-06 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1801401021 | Ortho Florida, LLC | Orthopaedic Surgery | 17425 7th St Ste 560174, Montverde, FL 34756-3206 | 2020-09-14 |
1801429022 | Ortho Florida, LLC | Orthopaedic Surgery | 2122 W Cypress Creek Rd Ste 202, Ft Lauderdale, FL 33309-1858 | 2020-02-17 |
1750913141 | Tyrance Orthopedics and Sports Medicine | Orthopaedic Surgery | 1620 S Congress Ave Ste 201, Palm Springs, FL 33461-2128 | 2020-02-04 |
1255979076 | Ortho Florida, LLC | Orthopaedic Surgery | 2122 W Cypress Crk Rd Ste 202, Fort Lauderdale, FL 33309-1858 | 2019-12-11 |
1730740218 | Baptist Physician Group LLC | Orthopaedic Surgery | 133 Racetrack Rd Nw, Fort Walton Beach, FL 32547-1644 | 2019-06-25 |
1164984720 | Ortho Florida, LLC | Orthopaedic Surgery | 21097 Ne 27th Ct Ste 590, Aventura, FL 33180-1246 | 2019-04-03 |
1578043998 | Bahri Orthopedics Institute | Orthopaedic Surgery | 6100 Kennerly Rd Ste 202, Jacksonville, FL 32216-4379 | 2018-08-15 |
1154834489 | Dorothy Richardson | Orthopaedic Surgery | 1120 W Lakeshore Dr, Clermont, FL 34711-2936 | 2017-11-08 |
1225541790 | Ortho Florida, LLC | Orthopaedic Surgery | 3702 Washington St Ste 202, Hollywood, FL 33021-8283 | 2017-11-07 |
1275046831 | Galaxy Wellness Sport and Rehabilitation Center LLC | Orthopaedic Surgery | 1951 Nw 7th St, Miami, FL 33125 | 2017-11-06 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.