Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ivy Wicks, MD

Individual provider Family Medicine Physician · NPI 1093247769

Ivy Wicks, MD is a Family Practice in Waldorf, Maryland. Graduated from Meharry Medical College School of Medicine in 2017, 9 years ago. Practices with Kaiser Foundation Health Plan of the Mid Atlantic States, Inc, a 1,934-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
9
Trained at
Meharry Medical College School of Medicine
Licensed in
MD
In the registry since
2017
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12070 Old Line Ctr Ste 302
Waldorf, MD 20602-2567
Phone: (301) 645-6667
Fax: (301) 870-9722
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence D0091620 (MD)

Record details

NPI number1093247769
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 31, 2017
Last updated in NPPESJune 5, 2026
Certification dateJune 5, 2026
Mailing address12070 Old Line Ctr Ste 302, Waldorf, MD 20602-2567

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolMEHARRY MEDICAL COLLEGE SCHOOL OF MEDICINE
Graduated 2017 (9 years in practice)
Group practice Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc — 1934 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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