Reginald Jack Widick

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

615 Issued in TN

Practice address

330 Franklin Rd
Suite 135a-121
Brentwood, TN 37027-3280

Phone

(270) 745-7182

NPI assigned

Apr 29, 2008

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Reginald J Widick

  • Hearing Instrument Specialist
  • Bowling Green, KY
  • NPI 1023362118
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1033384128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 FRANKLIN RD",
            "address_2": "SUITE 135A-121",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370273280",
            "telephone_number": "270-745-7182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 FRANKLIN RD",
            "address_2": "SUITE 135A-121",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370273280",
            "telephone_number": "270-745-7182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDICK",
        "first_name": "REGINALD",
        "middle_name": "JACK",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-29",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "TN",
            "license": "615",
            "primary": true
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "KY",
            "license": "834",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Hearing Instrument Specialist in Brentwood, TN
• Providers in Brentwood, TN by specialty
• Hearing Instrument Specialist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.