Douglas B Widener, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

063452 Issued in GA

Practice address

1495 Hickory Flat Hwy Ste 200
Canton, GA 30115-4229

Phone

(678) 505-4455

Fax

(678) 505-4446

NPI assigned

Jun 27, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Orthopedic Surgery

Education

Medical College of Georgia School of Medicine, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Resurgens, LLCGroup PAC ID 1153224142, 184 clinicians

Physiotherapy Associates IncGroup PAC ID 3577470442, shared by 50 NPIs, 1,432 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Amedisys Northwest Home Health Home health agency, Jasper, GA, CCN 117064
• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008
• Adventhealth Gordon Hospital, Calhoun, GA, CCN 110023
• Adventhealth Murray Hospital, Chatsworth, GA, CCN 110050
• Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

Merit-based Incentive Payment System (MIPS)

Final score

93.93 of 100Reported as apm

Quality

82.14

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: douglas.widener@hca5.eclinicaldirectplus.com
• Direct secure messaging: douglas.widener.1@15749.direct.athenahealth.com

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.

• Resurgens, LLC

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1386697928
  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System in Waycross, Inc.

  • Multi-Specialty Clinic/Center
  • Waycross, GA
  • NPI 1154745982
  Medicare reassignment NPD
• Resurgens, LLC

  • Orthopaedic Surgery Physician
  • Braselton, GA
  • NPI 1033919790
  NPD
• Integrated Regional Laboratories Pathology Services, LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Atlantis, FL
  • NPI 1942526298
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Adventist Health System Georgia, Inc.

  • General Acute Care Hospital
  • Chatsworth, GA
  • NPI 1750776571
  Care Compare affiliation
• Adventist Health System Georgia, Inc.

  • General Acute Care Hospital
  • Calhoun, GA
  • NPI 1760402424
  Care Compare affiliation
• Amedisys Northwest, L.L.C.

  • Home Health Agency
  • Jasper, GA
  • NPI 1588612188
  Care Compare affiliation
• Kennestone Hospital, Inc.

  • Long Term Care Hospital
  • Marietta, GA
  • NPI 1700853041

  Long-term care hospital

  Care Compare affiliation
• Northside Hospital, Inc.

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396
  Care Compare affiliation

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1104088566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1495 HICKORY FLAT HWY STE 200",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301154229",
            "telephone_number": "678-505-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1495 HICKORY FLAT HWY STE 200",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301154229",
            "telephone_number": "678-505-4455",
            "fax_number": "678-505-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDENER",
        "first_name": "DOUGLAS",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-27",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "063452",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikayla Beverly White
• Rachel Strickland White, RD
• Natalie Paris Whitehead, APC
• Ernest Lee Whitmarsh Jr., PH.D.
• Wickshire Canton Opco LLC
• Jongbin Wie, DMD
• Gina Marie Wiedrich, MT
• Benjamin Russell Wiener, MD
• Memorie S Wilcoxon, PHARMD
• David Wilder, DMD

• Orthopaedic Surgery Physician in Canton, GA
• Providers in Canton, GA by specialty
• Orthopaedic Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.