Patricia Diane Widenoja, BSN, MN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

078041667N1 Issued in OR

Practice address

85955 Raven Ridge LN
Silver Lake, OR 97638-9627

Phone

(541) 576-3070

Fax

(541) 576-3070

NPI assigned

Nov 11, 2005

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor on Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: patricia.widenoja@1454673297412.direct.elationemr.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellness Nursing's Way, Inc.

  • Primary Care Clinic/Center
  • Silver Lake, OR
  • NPI 1467848978
  Authorized official Same address or phone
• Clinicops LLC

  dba Oregon Integrated Health

  • Internal Medicine Physician
  • Florence, OR
  • NPI 1497251268
  NPD (past)

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

{
    "created_epoch": "1131667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1235110628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85955 RAVEN RIDGE LN",
            "city": "SILVER LAKE",
            "state": "OR",
            "postal_code": "976389627",
            "telephone_number": "541-576-3070",
            "fax_number": "541-576-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85955 RAVEN RIDGE LN",
            "city": "SILVER LAKE",
            "state": "OR",
            "postal_code": "976389627",
            "telephone_number": "541-576-3070",
            "fax_number": "541-576-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDENOJA",
        "first_name": "PATRICIA",
        "middle_name": "DIANE",
        "credential": "BSN, MN, FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-11-11",
        "last_updated": "2023-03-07",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "078041667N1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "ANP0170",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051750",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pwidenoja1029075@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "110 Center Ave",
            "city": "Molalla",
            "state": "OR",
            "country_code": "US",
            "postal_code": "970388134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lake County School Dist. #14 (North Lake School Dist. #14)
• Silver Lake Rural Fire Protection District
• Wellness Nursing's Way, Inc.

• Family Nurse Practitioner in Silver Lake, OR
• Providers in Silver Lake, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.