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Deactivated NPI 1528026366 Deactivated / Inactive NPI Male Practitioner

Dr. Otto W Wickstrom , MD

Orthopaedic Surgery • Columbus, IN

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Otto Wickstrom has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 02, 2006
NPI Deactivation Date August 24, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Otto Wickstrom, MD was a registered Orthopaedic Surgery practicing in Columbus, IN. Throughout an active medical career spanning 15 years, Dr. Wickstrom provided care at the practice location at 2360 N NATIONAL RD until profile deactivation on 2021-08-24.

Practice Location & Contact Primary Location

Practice Address

2360 N National Rd

Columbus, IN 472013732

Telephone 8123722437
Fax 8123792621
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Columbus, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.5 Yrs
State Avg: 26.1 Yrs
Regional Practice Density
9 Specialists

Practicing in Columbus, IN (530 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License IN 01018161A

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated August 24, 2021

Record deactivated on August 24, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2360 N NATIONAL RD, COLUMBUS, IN 472013732 (Tel: 8123722437)

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Updated Business Mailing Address July 08, 2007

Registered at 2360 N NATIONAL RD, COLUMBUS, IN 472013732 (Tel: 8123722437)

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Provider Name / Credentials Updated July 08, 2007

Recorded as OTTO WICKSTROM, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Orthopaedic Surgery (License #01018161A in IN)

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Initial NPI Registration & Enumeration May 02, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1528026366
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 02, 2006
Last Update: July 08, 2007
Deactivation Date: August 24, 2021

Mailing Address

2360 N National Rd

Columbus, IN 472013732

Phone: 8123722437

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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