Individual provider Active NPI

Nicole Marie Wedel, FNP-C

  • Family Nurse Practitioner
  • Weatherford, OK
National Provider Identifier
1053016642
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
212282 Issued in OK
Practice address
1303 N Washington St
Weatherford, OK 73096-2443
Phone
(580) 772-2820
NPI assigned
Apr 3, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 212282 OK Primary

Addresses

Primary practice location

1303 N Washington St
Weatherford, OK 73096-2443

Mailing address

2706 Cloud Nine Cir
Weatherford, OK 73096-2627
Phone (916) 467-2507

Other names 1

  • Nicole Marie Donato Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230511001713 OK Practitioner - Nurse Practitioner 1759747074 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Maranatha Family Company LLC CurrentSince Jun 9, 2024 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Apr 13, 2023 Accepting new patients
Williams Medical Group Practice, LLC CurrentSince Apr 13, 2023 Accepting new patients
Summit Medical Center Past Accepting new patients
Clinton Hospital Authority Past Accepting new patients

Locations

341 S 28th St
Clinton, OK 73601
Phone (580) 323-4644

411 W 3rd St
Elk City, OK 73644
Phone (580) 303-9293

220 S Van Buren St
Enid, OK 73703
Phone (580) 234-9355

777 NW 63rd St
Fl 2
Oklahoma City, OK 73116

701 Cedar Lake Blvd
Ste 120
Oklahoma City, OK 73114
Phone (405) 286-1170

1303 N Washington St
Weatherford, OK 73096
Phone (580) 772-2820

Interoperability endpoints

  • Direct secure messaging: nicole.wedel.1@27962.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1053016642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2706 CLOUD NINE CIR",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730962627",
            "telephone_number": "916-467-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1303 N WASHINGTON ST",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730962443",
            "telephone_number": "580-772-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEDEL",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "212282",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "DONATO",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Weatherford, OK

Sources for this page

Verify at the official NPI Registry.