Madeline Marie Wideman, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501018570 Issued in MI

Practice address

15500 19 Mile Rd Ste 330
Clinton Township, MI 48038-6313

Phone

(586) 412-0016

Fax

(586) 412-0117

NPI assigned

Feb 12, 2018

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Recovery Project, LLCGroup PAC ID 9739154311, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• The Recovery Project, LLC

  • Physical Therapist
  • Livonia, MI
  • NPI 1528137858
  Medicare reassignment Care Compare group NPD
• Fare to Freedom

  • Non-emergency Medical Transport (VAN)
  • Livonia, MI
  • NPI 1588903785
  NPD (past)

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1184123580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20000 VICTOR PKWY STE 100",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481527027",
            "telephone_number": "734-953-1745",
            "fax_number": "734-953-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15500 19 MILE RD STE 330",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480386313",
            "telephone_number": "586-412-0016",
            "fax_number": "586-412-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDEMAN",
        "first_name": "MADELINE",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501018570",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "5501018570",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tearani Latera White
• Matrina M Whitley, CRNA
• Paige N Whitmore
• James H Whitmyer, M.D.
• Andrea Wickham
• Wildflower Lion Integrative Therapy LLC
• Kathryn Wiley
• Michelle Janine Wilhelm
• Courtney Willhite
• Annie Noelle Williams, D.O.

• Physical Therapist in Clinton Township, MI
• Providers in Clinton Township, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.