Liam Wickenburg
NPI 1750074563 · Physician Assistant · Meridian, ID
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Liam Wickenburg is a Physician Assistant provider in Meridian, ID (NPI 1750074563).
Provider details
- NPI number
- 1750074563
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- No
- License
- 8871273 (ID)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 631 N Moonglow AveKuna, ID 83634-2198Phone: (707) 666-1096
Registry dates
- Enumerated
- 2023-05-29
- Last updated
- 2025-10-15
- Certified
- 2025-10-15
Frequently asked questions
- What is Liam Wickenburg's NPI number?
- Liam Wickenburg's National Provider Identifier (NPI) is 1750074563, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Liam Wickenburg's specialty?
- Liam Wickenburg is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Liam Wickenburg located?
- Liam Wickenburg's practice location on file with NPPES is 520 S Eagle Rd Ste 1241, Meridian, ID 83642-6355.
- What is Liam Wickenburg's phone number?
- The practice phone number listed in the NPPES registry for Liam Wickenburg is (208) 381-6930.
- Does Liam Wickenburg accept Medicare?
- Liam Wickenburg is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Liam Wickenburg's NPI active?
- Yes — Liam Wickenburg's NPI (1750074563) is active in the NPPES registry as of the last update on 2025-10-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.