Active NPI
Clare Wightman, MS, PA-C
- Medical Physician Assistant
- Denver, CO
National Provider Identifier
1346325099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 2184
- Practice address
- 488 Josephine St
Denver, CO 80206-4209 - Phone
- (720) 290-4200
- NPI assigned
- Oct 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 2184 | CO | Primary |
Addresses
Primary practice location
488 Josephine St
Denver, CO 80206-4209
Mailing address
488 Josephine St
Denver, CO 80206-4209
Phone (720) 290-4200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 29584779 | Medicaid | CO |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | 06/16/2021 | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Soma Physical Therapy | Past | Accepting new patients | |
| Advanced Dermatology of Colorado, PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dermatology Physician
- Fort Collins, CO
- NPI 1710370648
-
- Physical Therapist
- Boulder, CO
- NPI 1396801114
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689552000000",
"number": "1346325099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "488 JOSEPHINE ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802064209",
"telephone_number": "720-290-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "488 JOSEPHINE ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802064209",
"telephone_number": "720-290-4200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIGHTMAN",
"first_name": "CLARE",
"credential": "MS, PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-25",
"last_updated": "2023-07-17",
"certification_date": "2023-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "CO",
"license": "2184",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "29584779",
"state": "CO"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "06/16/2021",
"affiliation": "N",
"endpointDescription": "contract ended",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2400 Spruce St Ste 101",
"city": "Boulder",
"state": "CO",
"country_code": "US",
"postal_code": "803024716",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.