LIA MICHELE WICKERHAM (NPI# 1902499411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902499411 |
| Entity Type | Individual |
| Full Name | LIA MICHELE WICKERHAM |
| Gender | Female |
| Practice Address | 300 Longwood Ave Boston MA 02115-5724 |
| Practice Telephone | 6173556000 |
| Mailing Address | 300 Longwood Ave Boston MA 02115-5724 |
| Mailing Telephone | 6173556000 |
| Certification Date | 2021-02-16 |
| Enumeration Date | 2021-02-16 |
| Last Update Date | 2021-02-16 |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | Group | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|---|
| Y | 363LP0200X | Nurse Practitioner Specialization: Pediatrics | 2306126 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address | 300 LONGWOOD AVE |
| City | BOSTON |
| State | MA |
| Zip Code | 02115-5724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063006518 | Lindsey Barlow | Nurse Practitioner · Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2021-02-25 |
| 1114511748 | Annemarie Kerry | Nurse Practitioner · Neonatal, Critical Care | 300 Longwood Ave, Boston, MA 02115-5724 | 2021-02-24 |
| 1215520184 | Sophie Foss | Clinical Neuropsychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2021-02-11 |
| 1144812710 | Allison Ryann Mcguinness | Occupational Therapist | 300 Longwood Ave, Boston, MA 02115-5724 | 2021-02-05 |
| 1891384707 | Shawn Hamilton Kelly | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2021-01-14 |
| 1871182055 | Kathleen Elizabeth Mavrogiannis · Kathleen Elizabeth Joumas | Nurse Practitioner · Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2021-01-13 |
| 1629665302 | Abdulrahman Aldeeri | Medical Genetics · Clinical Genetics (M.D.) | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-12-28 |
| 1558967463 | Jeffrey Pierre-Paul | Pharmacist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-12-07 |
| 1053916254 | Francesca Sperotto | Pediatrics · Pediatric Cardiology | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-12-03 |
| 1124623988 | Lauren Kracoff | Occupational Therapist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-12-01 |
| Find all providers in the same address | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487159851 | Gareth Marshall | Student in an Organized Health Care Education/Training Program | Boston Children's Hospital 300 Longwood Ave, Boston, MA 02115-5724 | 2018-03-28 |
| 1164832606 | Olga I. Perez | Social Worker · Clinical | 328 Commonwealth Avenue, Apartment 1, Boston, MA 02115-5724 | 2014-05-06 |
| 1578823043 | Dan Loberman | Surgery · Vascular Surgery | 27 Park Street, Hyannis, MA 02115-5724 | 2012-05-18 |
| 1922268424 | Eric N Feins | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Boston Children's Hospital -- 300 Longwood Avenue, Bader, 2nd Floor, Boston, MA 02115-5724 | 2008-06-10 |
| 1154535318 | Carolyn A Stickney | Internal Medicine | 333 Longwood Ave, Lo 011, Critical Care Medicine, Boston Children's Hospital, Boston, MA 02115-5724 | 2007-05-09 |
| 1104961606 | Boston Brace International Inc. · Nopco | Prosthetic/Orthotic Supplier | 319 Longwood Ave, Suite 102, Boston, MA 02115-5724 | 2007-02-21 |
| 1396776159 | David A Kane | Pediatrics | Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115-5724 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316532187 | Mary Louise Gargan | Student in an Organized Health Care Education/Training Program | 75 Francis Street Brigham and Women's Hospital. Abdomin, Boston, MA 02115 | 2021-03-04 |
| 1720678592 | Abdulrhman Aleisa | Student in an Organized Health Care Education/Training Program | 75 Francis Street, Boston, MA 02115 | 2021-01-25 |
| 1659961662 | Shixiao He | Student in an Organized Health Care Education/Training Program | 75 Francis Street, Suite Bc-3-010, Boston, MA 02115 | 2021-01-23 |
| 1760083067 | Tracy Ng | Social Worker · Clinical | 75 Francis Street, Care Continuum Management, Boston, MA 02115 | 2020-11-03 |
| 1275132078 | Olivia Wilkins | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave, 202 Robinson Hall Physician Assistant Program, Boston, MA 02115 | 2020-10-22 |
| 1386241727 | Vishal Ruparelia | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-10-08 |
| 1043817620 | Kelly Cornelison | Student in an Organized Health Care Education/Training Program | 336 Huntington Ave, Boston, MA 02115 | 2020-10-06 |
| 1053918714 | Meghan Patricia Ahearn | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue, 202 Robinson Hall, Boston, MA 02115 | 2020-10-06 |
| 1073110011 | Crystal Rodriguez | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue, 202 Robinson Hall, Boston, MA 02115 | 2020-10-02 |
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| Find all providers in zip 02115 | ||||
| Taxonomy Code | 363LP0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063006518 | Lindsey Barlow | 300 Longwood Ave, Boston, MA 02115-5724 | 2021-02-25 | |
| 1871182055 | Kathleen Elizabeth Mavrogiannis · Kathleen Elizabeth Joumas | 300 Longwood Ave, Boston, MA 02115-5724 | 2021-01-13 | |
| 1356945463 | Tayler Marie O'Donnell | 330 Brookline Ave, Boston, MA 02215-5491 | 2020-11-30 | |
| 1356948525 | Kaylee Woods | 85 Seaport Blvd Unit 714, Boston, MA 02210-2157 | 2020-10-01 | |
| 1558976845 | Hilary Segar Garber · Hilary Caroline Segar | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-13 | |
| 1184233470 | Jayme Elizabeth Kelly | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-07-23 | |
| 1144838384 | Amanda Rose Bakos | 218 Marion St, Boston, MA 02128-1758 | 2020-07-14 | |
| 1396368460 | Lauren Sell | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-05-25 | |
| 1083236749 | Mubina M Rhee | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-05-15 | |
| 1033738307 | Angelli Aguilar | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-04-15 | |
| Find all providers in BOSTON | ||||
| City | BOSTON |
| Zip Code | 02115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306848148 | Donald Lawrence Wickerham · D Lawrence Wickerham | Surgery · Surgical Oncology | 320 E North Ave, Pittsburgh, PA 15212-4756 | 2005-08-11 |
| 1215407283 | Carrie Wickerham | Technician | 227 Main St, Festus, MO 63028-1952 | 2018-12-03 |
| 1588905004 | Kristen Nicole Wickerham | Counselor | 237 6th Street, Pittsburgh, PA 15238 | 2013-03-07 |
| 1891934329 | Rebecca Wickerham | Registered Nurse | 3769 Hunting Ln, Gahanna, OH 43230-4017 | 2009-02-06 |
| 1114433893 | Allyson Elizabeth Billings Wickerham | Peer Specialist | 419 E 7th St Ste 207, The Dalles, OR 97058-2676 | 2017-12-18 |
| 1275959876 | Blake Wickerham | Specialist/Technologist · Athletic Trainer | 3121 Woods Pl, Raleigh, NC 27607-5231 | 2014-03-07 |
| 1821506668 | Jacquelyn Wickerham | Behavior Technician | 6100 Veterans Pkwy Ste 11, Columbus, GA 31909-3514 | 2018-01-15 |
| 1194253500 | Andrew Lawrence Wickerham | Internal Medicine | 3322 N Broad St, Philadelphia, PA 19140-5185 | 2017-05-30 |
| 1578619235 | Rebeccah Shierson Wickerham | Emergency Medicine | 1900 Randolph Rd, Suite 900, Charlotte, NC 28207-1122 | 2007-01-26 |
| 1699253997 | Kelsey Lynne Wickerham | Behavior Technician | 74710 Highway 111 Ste 102, Palm Desert, CA 92260-3820 | 2018-07-30 |
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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.