DR. JENNA WICKERSHAM (NPI# 1538579271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538579271 |
| Entity Type | Individual |
| Full Name | DR. JENNA WICKERSHAM |
| Credential | D.O. |
| Practice Address |
100 Mac Ln Pierre SD 57501-3391 |
| Practice Telephone | 6052245901 |
| Practice Fax Number | 6059455083 |
| Mailing Telephone | 6052245901 |
| Mailing Fax Number | 6059455083 |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2019-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 10716 | SD | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 0085 | SD | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1115 E 20th St, Sioux Falls, SD 571051013 | 6055751644 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841726551 | Jenna Wickersham | Pharmacist | 2129 S Main St, Bellefontaine, OH 43311-1557 | 2017-05-02 |
| Street Address |
100 MAC LN |
| City | PIERRE |
| State | SD |
| Zip Code | 57501-3391 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770514234 | Vilas Pharmacy | Durable Medical Equipment & Medical Supplies | 100 Mac Ln, Suite #2, Pierre, SD 57501-3391 | 2006-07-05 |
| 1134750011 | Kacey Beth Hutchison | Social Worker | 100 Mac Ln, Pierre, SD 57501-3391 | 2020-01-30 |
| 1578028981 | Jada Hawkinson | Nurse Practitioner | 100 Mac Ln, Pierre, SD 57501-3391 | 2019-02-11 |
| 1205308095 | Wren Hollingsworth | Nurse Practitioner | 100 Mac Ln, Pierre, SD 57501-3391 | 2018-12-18 |
| 1326518556 | Jessica Rumpca | Nurse Practitioner | 100 Mac Ln, Pierre, SD 57501-3391 | 2018-11-30 |
| 1750865192 | Kelsey Marie Hupp | Nurse Practitioner | 100 Mac Ln, Pierre, SD 57501-3391 | 2018-09-21 |
| 1073097895 | Ali Marie Smith | Nurse Practitioner | 100 Mac Ln, Pierre, SD 57501-3391 | 2018-09-18 |
| 1609357623 | Brittany Bo Kerr | Physician Assistant | 100 Mac Ln, Pierre, SD 57501-3391 | 2018-08-27 |
| 1881196319 | Allison Jo Bradshaw | Nurse Practitioner | 100 Mac Ln, Pierre, SD 57501 | 2018-02-28 |
| 1932651122 | Avera St. Mary's | Pharmacy | 100 Mac Ln, Suite 101, Pierre, SD 57501-3391 | 2016-11-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518420694 | Shawna K Fullerton | Social Worker | 1309 E Wells Ave, Pierre, SD 57501 | 2019-04-07 |
| 1841779758 | Joanne Sarringar | Physical Therapist | 801 E. Sioux Avenue, Pierre, SD 57501 | 2018-08-10 |
| 1003234832 | Katherine Bonnichsen | Dermatology | Avera Medical Group Pierre - Helmsley Center, 801 E Sioux Ave, Pierre, SD 57501 | 2014-03-29 |
| 1417232166 | Louis J Van Roekel | Pharmacist | 100 E Sioux, Pierre, SD 57501 | 2011-10-13 |
| 1508164401 | Bechtold Thompson Dental Clinic | Dentist | 640 E. Sioux Ave, Pierre, SD 57501 | 2011-03-02 |
| 1417180969 | Dentistry At The St. Charles LLC | Dentist | 207 E. Capitol Ave. Ste 201, Pierre, SD 57501 | 2009-09-01 |
| 1063663995 | Buron O. Lindbloom | Family Medicine | 3200 E. Hwy 34, S.d. Womens Prison, Pierre, SD 57501 | 2008-10-09 |
| 1831221522 | Curt C Kuehl | Chiropractor | 430 W Sioux Ave, Pierre, SD 57501 | 2007-03-09 |
| 1376603092 | Tim Wald | Physical Therapist | 1012 Woodview Dr #20, Pierre, SD 57501 | 2006-12-11 |
| 1184702540 | Tami Lynn Hogie-lorenzen | Nurse Practitioner | 1714 Abbey Road, Pierre, SD 57501 | 2006-11-02 |
| Find all providers in zip 57501 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063663995 | Buron O. Lindbloom | Family Medicine | 3200 E. Hwy 34, S.d. Womens Prison, Pierre, SD 57501 | 2008-10-09 |
| 1912927831 | Onida Area Development Corporation | Family Medicine | 1601 N Harrison Ave, Ste # 1b, Pierre, SD 57501-2378 | 2006-07-21 |
| 1639126071 | Joseph Simon Villa | Family Medicine | 800 E Dakota Ave, Pierre, SD 57501-3313 | 2006-05-30 |
| 1760487664 | Dakota Plains Clinic, LLP | Family Medicine | 640 E Sioux Ave, Pierre, SD 57501-3300 | 2005-06-16 |
| 1467807917 | Joseph Swedzinski | Family Medicine | 801 E Sioux Ave, Pierre, SD 57501-3323 | 2016-05-03 |
| 1629411574 | Kirk K Livermont | Family Medicine | 521 E Sioux Ave, Pierre, SD 57501-3142 | 2013-04-10 |
| 1245595081 | Robert Allen Johnson | Family Medicine | 521 E Sioux Ave, Pierre, SD 57501-3142 | 2012-07-09 |
| 1871743401 | Barbara K Spears | Family Medicine | 400 W 5th St, Pierre, SD 57501-1411 | 2008-09-18 |
| 1255404075 | Sanford Clinic | Family Medicine | 521 E Sioux Ave, Pierre, SD 57501-3142 | 2006-11-17 |
| 1316987985 | Noel Dennis Chicoine | Family Medicine | 521 E Sioux Ave, Pierre, SD 57501-3142 | 2006-06-08 |
| Find all providers in PIERRE | ||||
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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.