NPI age
5 years
Enumerated 2020-11-18
● Active
Type 1 · Individual
Walter Jordan Wickham, DPT
Wickham is 1 of 8 physical medicine & rehabilitation providers in Pocatello and 1 of 98 in Idaho.
Primary specialty
Physical Medicine & Rehabilitation
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2020-11-18
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 98 active physical medicine & rehabilitation providers in Idaho.
NPI age
5 years
↓ 5 yr below median (10 yr)
State licenses
1 state
18% of peers hold multiple states
Subspecialties
0
29% of peers hold subspecialties
NPI lifetime · 2020 → 2026
2020-11Enumerated in NPPES
2020
2026
Where they practice
Practice location
1800 Flandro Dr Ste 190
Pocatello, ID 832024940
Mailing address
1800 Flandro Dr Ste 190
Pocatello, ID 832024940
Specialties
-
Physical Medicine & Rehabilitation PrimaryPhysical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from...
Practice context
Part of a multi-provider practice. 13 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.