Active NPI
Shlomo Widder, M.D.
- Specialist
- Vienna, VA
National Provider Identifier
1093836330
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 0101040488
- Practice address
- 8230 Leesburg Pike
Suite 630
Vienna, VA 22182-2639 - Phone
- (703) 506-0300
- Fax
- (703) 506-0363
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 0101040488 | VA | Primary |
Addresses
Primary practice location
8230 Leesburg Pike
Suite 630
Vienna, VA 22182-2639
Mailing address
8230 Leesburg Pike
Suite 630
Vienna, VA 22182-2639
Phone (703) 506-0300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101040488 | VA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190678400000",
"number": "1093836330",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8230 LEESBURG PIKE",
"address_2": "SUITE 630",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822639",
"telephone_number": "703-506-0300",
"fax_number": "703-506-0363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8230 LEESBURG PIKE",
"address_2": "SUITE 630",
"city": "VIENNA",
"state": "VA",
"postal_code": "221822639",
"telephone_number": "703-506-0300",
"fax_number": "703-506-0363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDDER",
"first_name": "SHLOMO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2007-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "VA",
"license": "0101040488",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vienna, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.