Mary Ann Widman, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP2864 Issued in AZ

Practice address

1713 S Kofa Ave
Suite a
Parker, AZ 85344-6477

Phone

(928) 669-9700

Fax

(928) 669-9104

NPI assigned

Oct 9, 2007

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 AZ

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HRMC, LLCGroup PAC ID 3072641265, 33 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Havasu Regional Medical Center Home Health Home health agency, Lake Havasu City, AZ, CCN 037057
• Havasu Regional Medical Center Hospital, Lake Havasu City, AZ, CCN 030069
• La Paz Regional Hospital Hospital, Parker, AZ, CCN 031317

Merit-based Incentive Payment System (MIPS)

Final score

96.6 of 100Reported as group

Promoting interoperability

96

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/19231/brand/1/csg/1/fhir/r4
• Direct secure messaging: mary.widman.1@19231.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.

• HRMC, LLC

  • Hematology & Oncology Physician
  • Lake Havasu City, AZ
  • NPI 1003139387
  Medicare reassignment Care Compare group NPD
• HRMC, LLC

  • Nurse Practitioner
  • Lake Havasu City, AZ
  • NPI 1891155974
  NPD
• HRMC, LLC

  • Internal Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1932610482

  Nurse Practitioner

  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1073583472
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • Show Low, AZ
  • NPI 1073740098
  NPD
• North Country Healthcare, Inc.

  • Family Medicine Physician
  • Flagstaff, AZ
  • NPI 1619345675
  NPD
• North Country Healthcare, Inc.

  • Multi-Specialty Clinic/Center
  • St. Johns, AZ
  • NPI 1689799827
  NPD
• HRMC, LLC

  • Internal Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1447630538
  NPD (past)
• North Country Healthcare Inc

  • Multi-Specialty Clinic/Center
  • Flagstaff, AZ
  • NPI 1053587261
  NPD (past)

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

• Arizona in-Home Partner-I, LLC

  • Home Health Agency
  • Lake Havasu City, AZ
  • NPI 1487190658
  Care Compare affiliation
• Havasu Regional Medical Center LLC

  • Rural Acute Care Hospital
  • Lake Havasu City, AZ
  • NPI 1780761866
  Care Compare affiliation
• La Paz Regional Hospital Inc

  • Critical Access Hospital
  • Parker, AZ
  • NPI 1053684555
  Care Compare affiliation
• La Paz Regional Hospital Inc., Dba Parker Podiatry

  • Podiatrist
  • Parker, AZ
  • NPI 1568875771

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429056000000",
    "number": "1245428929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1713 S KOFA AVE",
            "address_2": "SUITE A",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853446477",
            "telephone_number": "928-669-9700",
            "fax_number": "928-669-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1713 S KOFA AVE",
            "address_2": "SUITE A",
            "city": "PARKER",
            "state": "AZ",
            "postal_code": "853446477",
            "telephone_number": "928-669-9700",
            "fax_number": "928-669-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDMAN",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2015-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP2864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00458072",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheaber Welch, RN BSN
• Western Urological Associates, PC
• Kenneth James Westrate, M.D.
• Roxane Jean White
• Connie R Whitener, BSN
• Dena Lynn Wilson, M.D.
• Burns Maxwell Winter, RN
• Theresa Suzanne Wolven
• Shiquita Michelle Wonderly, RN
• Gillian Reed Woodruff, MD

• Family Nurse Practitioner in Parker, AZ
• Providers in Parker, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; 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.