Jennifer Renee Wiederhold, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024198588 Issued in VA

Practice address

4049 Main St
Chincoteague Island, VA 23336-2406

Phone

(757) 336-3682

Fax

(757) 336-3703

NPI assigned

Mar 23, 2021

Last updated

Sep 1, 2026By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788220800000",
    "number": "1447836929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20280 MARKET ST",
            "city": "ONANCOCK",
            "state": "VA",
            "postal_code": "234171331",
            "telephone_number": "757-414-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4049 MAIN ST",
            "city": "CHINCOTEAGUE ISLAND",
            "state": "VA",
            "postal_code": "233362406",
            "telephone_number": "757-336-3682",
            "fax_number": "757-336-3703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5219 Lankford Hwy",
            "address_purpose": "LOCATION",
            "city": "New Church",
            "state": "VA",
            "postal_code": "234153332",
            "country_code": "US",
            "telephone_number": "757-824-5676",
            "fax_number": "757-824-5872",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "20306 Badger Lane",
            "address_purpose": "LOCATION",
            "city": "Onley",
            "state": "VA",
            "postal_code": "23418",
            "country_code": "US",
            "telephone_number": "757-787-7374",
            "fax_number": "757-787-4513",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25228 Lankford Highway",
            "address_purpose": "LOCATION",
            "city": "Onley",
            "state": "VA",
            "postal_code": "23418",
            "country_code": "US",
            "telephone_number": "757-414-0400",
            "fax_number": "757-414-0569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17068 Lankford Highway",
            "address_purpose": "LOCATION",
            "city": "Eastville",
            "state": "VA",
            "postal_code": "23347",
            "country_code": "US",
            "telephone_number": "757-331-1086",
            "fax_number": "757-442-9505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIEDERHOLD",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2026-09-01",
        "certification_date": "2026-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024198588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Chincoteague Island, VA
• Providers in Chincoteague Island, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.