Widmark Roy Dwyer

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

T520553726280 Issued in FL

Practice address

22 Unicorn CT
Palm Coast, FL 32164-5760

Phone

(561) 692-1925

NPI assigned

Dec 13, 2016

Last updated

Dec 13, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1386188159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 UNICORN CT",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645760",
            "telephone_number": "561-692-1925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 UNICORN CT",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "321645760",
            "telephone_number": "561-692-1925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DWYER",
        "first_name": "WIDMARK",
        "middle_name": "ROY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "FL",
            "license": "T520553726280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Paul Dumas, PTA
• Priscilla Diane Duncan, DPT
• Amy Nicole Dunlap
• Dva Healthcare Renal Care Inc (Palm Coast Dialysis)
• Jamie Dwyer
• Jessica Eads
• East Central Florida Outpatient Imaging LLC (Town Center Imaging)
• East Central Florida Outpatient Imaging, LLC (Palm Coast Imaging Center)
• East Coast Habilitation Options
• East Coast Medical Staffing Inc

• Home Health Registered Nurse in Palm Coast, FL
• Providers in Palm Coast, FL by specialty
• Home Health Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; 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.