Karen S Widdoes, PT, MDT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

J10000289 Issued in DE

Practice address

4102 Ogletown Stanton Rd
Newark, DE 19713-4169

Phone

(302) 894-1800

Fax

(302) 894-1811

NPI assigned

Jun 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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 Heart and Vascular Care, LTD.

  • Cardiovascular Disease Physician
  • Yuma, AZ
  • NPI 1902071590
  NPD (past)

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1215979703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4102 OGLETOWN STANTON RD",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197134169",
            "telephone_number": "302-894-1800",
            "fax_number": "302-894-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDOES",
        "first_name": "KAREN",
        "middle_name": "S",
        "credential": "PT, MDT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-11",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DE",
            "license": "J10000289",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT008698E",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000038044",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "336345",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PT008698E",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH/IBC",
            "identifier": "0682261000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DE LICENSE",
            "identifier": "J10000289",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH IBC",
            "identifier": "0682261000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barbara A Whittenburg, LPCMH
• Bradley Stanford Why, FPMHNP
• Colleen Whyte, PHARMD
• Grace A Wiatrowski, FNP
• Jill Widdoes
• Willy Widjaya, M.D.
• Shannon Wieloch, M.S.
• Amy Wierschke
• Suzanne Marie Wiesenberg, PT
• Susan Wiggins

• Physical Therapist in Newark, DE
• Providers in Newark, DE by specialty
• Physical Therapist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.