Individual provider Active NPI

Sharan Wieberdink, FNP

  • Family Nurse Practitioner
  • San Manuel, AZ
National Provider Identifier
1467807131
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP8667 Issued in AZ
Practice address
23 S McNab Pkwy
San Manuel, AZ 85631
Phone
(520) 385-2234
NPI assigned
Apr 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP8667 AZ Primary

Addresses

Primary practice location

23 S McNab Pkwy
San Manuel, AZ 85631

Mailing address

PO Box 10097
Casa Grande, AZ 85130-0020
Phone (520) 836-3446

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160526002141 AZ Practitioner - Nurse Practitioner 3274823653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Linda Wroten PCGroup PAC ID 5597771394, 10 clinicians

Practice addresses (Care Compare)

5486 N Via Papavero
Tucson, AZ 85750-6056
Phone (520) 314-3412

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Linda Wroten P.C. Nurse Practitioner CurrentSince Jan 1, 2018 Accepting new patients
Sun Life Family Health Center, Inc. Past Accepting new patients
Sun Life Family Health Center, Inc Past Accepting new patients

Locations

6890 E Sunrise Dr
Ste 120176
Tucson, AZ 85750
Phone (520) 314-3412

12650 N Beach St
Ste 11425
Fort Worth, TX 76244

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1467807131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10097",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851300020",
            "telephone_number": "520-836-3446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 S MCNAB PKWY",
            "city": "SAN MANUEL",
            "state": "AZ",
            "postal_code": "85631",
            "telephone_number": "520-385-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEBERDINK",
        "first_name": "SHARAN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP8667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Manuel, AZ

Sources for this page

Verify at the official NPI Registry.