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Active NPI 1669434437 Individual Practitioner Male Practitioner

Dr. Thomas C. Kickham , DO

General Practice • Walhalla, SC

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Kickham, DO is a registered healthcare professional specializing in General Practice in Walhalla, SC. Practice services are available at 200 BOOKER DR under active NPI credentials.

Frequently performed procedures and clinical services include follow-up hospital inpatient care per day, subsequent hospital care with moderate levelof medical decision making, if using time, at least, routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

200 Booker Dr

Walhalla, SC 296912278

Telephone 8646563076
Fax 8439859562
Associated Practice Facility / Clinic
🏢 Clemson University Facility NPI 1093990707

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Walhalla, SC

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 27.3 Yrs
Regional Practice Density
1 Specialists

Practicing in Walhalla, SC (173 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

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99231 Follow-up hospital inpatient care per day, typically 15 minutes
70 25 $34.67 $34.67
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
57 27 $64.28 $64.28

Medical Specialties & State Licenses

CMS Verified: 2023-12-13
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License SC 241

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Emergency Medicine

NUCC Taxonomy Code: 207P00000X

State License SC 241

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
000925306A (GA)
Medicaid State Provider ID
002419 (SC)
Medicaid State Provider ID
89066G1 (NC)

Secondary Practice Locations

800 N Fant St

Anderson, SC 296215708

Phone: 8645121335

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Whitney Williams , NP-C

Nurse Practitioner - Family

NPI 1053794438

Nurse Practitioner (Certified)

Dr. Paula Watt , PhD, APRN-BC, FNP

Nurse Practitioner - Family

NPI 1083785018

Doctor of Philosophy (Ph.D.), APRNBC, Family Nurse Practitioner

Cherrish Kyle , NP

Nurse Practitioner - Family

NPI 1174974687

Nurse Practitioner

Christina Smith , FNP

Nurse Practitioner - Family

NPI 1518511229

Family Nurse Practitioner

William Mayo , APRN

Nurse Practitioner - Family

NPI 1558817809

Advanced Practice Registered Nurse

Jacqueline Wiles , APRN, FNP-BC

Nurse Practitioner - Family

NPI 1588211197

Advanced Practice Registered Nurse, Family Nurse Practitioner (Board Certified)

Career & Practice History Timeline

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

9 Historical Events
📍
Updated Practice Location October 21, 2022

Registered at 200 BOOKER DR, WALHALLA, SC 296912278 (Tel: 8646563076)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 21, 2022

Emergency Medicine (License #241 in SC)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 20, 2022

General Practice (License #241 in SC)

NPI Profile Active March 30, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location March 30, 2015

Registered at 800 N FANT ST, ANDERSON, SC 296215708 (Tel: 8645121335)

📍
Updated Business Mailing Address March 30, 2015

Registered at 800 N FANT ST, ANDERSON, SC 296215708 (Tel: 8645121335)

👤
Provider Name / Credentials Updated March 30, 2015

Recorded as THOMAS KICKHAM, D.O.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 30, 2015

Emergency Medicine (License #241 in SC)

🟢
Initial NPI Registration & Enumeration April 05, 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: 1669434437
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 05, 2006
Last Update: December 13, 2023
Sole Proprietor: No

Mailing Address

800 N Fant St

Anderson, SC 296215708

Phone: 8645121335

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

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.