Active NPI
Steven Jones Wideman, DPM
- Podiatrist
- Ogden, UT
National Provider Identifier
1437401932
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 104209-0501
- Practice address
- 3590 Harrison Blvd
#G-1
Ogden, UT 84403-2060 - Phone
- (801) 627-2122
- Fax
- (801) 627-2125
- NPI assigned
- Oct 8, 2012
- Last updated
- Oct 8, 2012
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 104209-0501 | UT | Primary |
Addresses
Primary practice location
3590 Harrison Blvd
#G-1
Ogden, UT 84403-2060
Mailing address
3590 Harrison Blvd
#G-1
Ogden, UT 84403-2060
Phone (801) 627-2122
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104209-0501 | UT | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349654400000",
"number": "1437401932",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3590 HARRISON BLVD",
"address_2": "#G-1",
"city": "OGDEN",
"state": "UT",
"postal_code": "844032060",
"telephone_number": "801-627-2122",
"fax_number": "801-627-2125"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3590 HARRISON BLVD",
"address_2": "#G-1",
"city": "OGDEN",
"state": "UT",
"postal_code": "844032060",
"telephone_number": "801-627-2122",
"fax_number": "801-627-2125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDEMAN",
"first_name": "STEVEN",
"middle_name": "JONES",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-10-08",
"last_updated": "2012-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "UT",
"license": "104209-0501",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 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.