Theresa A Weidemann, FNP-BC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

CNP-57254 Issued in NM

Practice address

933 Bradbury Dr SE Ste 2222
Albuquerque, NM 87106

Phone

(505) 272-3120

Fax

(505) 272-8060

NPI assigned

May 6, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NM

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Gastroenterology AssociatesGroup PAC ID 2062316086, 27 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lovelace Women'S Hospital Hospital, Albuquerque, NM, CCN 320017
• Lovelace Medical Center Hospital, Albuquerque, NM, CCN 320009

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: theresa.weidemann.1@12517.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/12517/brand/1/csg/1/fhir/r4

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.

• Southwest Gastroenterology Associates

  • Specialist
  • Albuquerque, NM
  • NPI 1902931728
  Medicare reassignment Care Compare group NPD
• Unm Hospital

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1689747552
  Medicare reassignment NPD
• Unm Hospital

  • Air Ambulance
  • Albuquerque, NM
  • NPI 1558054684
  NPD

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

• Lovelace Health System LLC

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1306914213
  Care Compare affiliation
• Lovelace Health System, LLC

  • General Acute Care Hospital
  • Albuquerque, NM
  • NPI 1982799375
  Care Compare affiliation

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

{
    "created_epoch": "1557100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1154986040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE STE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064375",
            "telephone_number": "505-272-3120",
            "fax_number": "505-272-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE STE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "87106",
            "telephone_number": "505-272-3120",
            "fax_number": "505-272-8060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6027 Ursa Ave NW",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871143510",
            "country_code": "US",
            "telephone_number": "505-280-6052",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "933 Bradbury Dr SE Ste 2222",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "87106",
            "country_code": "US",
            "telephone_number": "505-272-3120",
            "fax_number": "505-272-8060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WEIDEMANN",
        "first_name": "THERESA",
        "middle_name": "A",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-06",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NM",
            "license": "CNP-57254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "UNMH@direct.health.unm.edu",
            "affiliation": "N",
            "address_1": "2211 Lomas Blvd NE",
            "city": "Albuquerque",
            "state": "NM",
            "country_code": "US",
            "postal_code": "871062719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Katie P Weems, MPT
• Jenifer Weese, PHARM D
• Kira Elizabeth Wege
• Ann Ouellette Wehr, M.D.
• David Weichbrodt
• Matthew Payton Weidner, MD
• Justin Weigl, LMSW
• Aspen Grace Weigold
• Elizabeth R Weil, MD
• Kathleen Sheridan Weiland, RN

• Pediatric Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Pediatric Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.