Active NPI
Mary Widener
- Physician Assistant
- Gillette, WY
National Provider Identifier
1508164856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 511
- Practice address
- 407 S Medical Arts CT Ste F
Gillette, WY 82716-3372 - Phone
- (307) 688-9255
- NPI assigned
- Mar 10, 2011
- Last updated
- May 24, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA53799 | CA | |
| Physician Assistant | 363A00000X | 511 | WY | Primary |
Addresses
Primary practice location
407 S Medical Arts CT Ste F
Gillette, WY 82716-3372
Mailing address
407 S Medical Arts CT Ste F
Gillette, WY 82716-3372
Other practice location 1
1401 W 5th St
Sheridan, WY 82801-2705
Phone (307) 672-1100
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mwidener@sjmc.cernerdirect.com | Direct | |
| Direct Messaging Address | mwidener@sheridan.cernerdirect.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WY, CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1470 Sugarland Dr
Suite 1
Sheridan, WY 82801-5774
Phone (307) 673-2411
3345 W Cody LN
Unit 9
Teton Village, WY 83025-0544
Phone (307) 739-7346
625 E Broadway Ave
Jackson, WY 83001-8642
Phone (307) 733-3636
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.21 of 100
- Quality
- 80.49
- Promoting interoperability
- 94
- Improvement activities
- 40
- Cost
- 68.55
Merit-based Incentive Payment System (MIPS)
- Final score
- 81.82 of 100
- Quality
- 67.1
- Promoting interoperability
- 98
- Improvement activities
- 40
- Cost
- 73.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 511 | WY | MD | Psychologist |
| 53799 | CA | MD | Ambulatory Care Pharmacist |
| PA53799 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital of Sheridan County | Current | Accepting new patients | |
| Memorial Hospital of Sheridan County | Current | Accepting new patients | |
| Teton County Hospital District | Current | Accepting new patients | |
| Pinnacle Emergency Physicians of Bakersfield, a Professional Corp | Current | Accepting new patients | |
| Sheridan Memorial Sameday Health & Imaging Urgent Care | Past | Accepting new patients |
Locations
420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647
1333 W 5th St
Ste 110
Sheridan, WY 82801
Phone (307) 675-4610
1401 W 5th St
Sheridan, WY 82801
Phone (307) 672-1000
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/d7c7003a-96ae-4246-aaaa-19b18f13056e/
- mwidener@sheridan.cernerdirect.com
- mwidener@sjmc.cernerdirect.com
Organizations & group practices 7
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba St John's Health
- General Practice Physician
- Jackson, WY
- NPI 1487818605
-
dba Sheridan Memorial Clinics
- Internal Medicine Physician
- Sheridan, WY
- NPI 1861722688
-
dba Sheridan Memorial Hospital
- General Acute Care Hospital
- Sheridan, WY
- NPI 1487707188
-
dba Pinnacle Emergency Physicians of Bakersfield A Professional
- Emergency Medicine Physician
- Bakersfield, CA
- NPI 1619153251
-
dba Sheridan Memorial Hospital Hospice
- Community Based Hospice Care Agency
- Sheridan, WY
- NPI 1144359423
-
- Emergency Medicine Physician
- Bakersfield, CA
- NPI 1639415862
-
- Urgent Care Clinic/Center
- Sheridan, WY
- NPI 1124764915
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Sheridan Memorial Hospital
- General Acute Care Hospital
- Sheridan, WY
- NPI 1487707188
-
dba St John's Medical Center/ or St John's Health
- General Acute Care Hospital
- Jackson, WY
- NPI 1801835475
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1621814400000",
"number": "1508164856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "407 S MEDICAL ARTS CT STE F",
"city": "GILLETTE",
"state": "WY",
"postal_code": "827163372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "407 S MEDICAL ARTS CT STE F",
"city": "GILLETTE",
"state": "WY",
"postal_code": "827163372",
"telephone_number": "307-688-9255"
}
],
"practiceLocations": [
{
"address_1": "1401 W 5th St",
"address_purpose": "LOCATION",
"city": "Sheridan",
"state": "WY",
"postal_code": "828012705",
"country_code": "US",
"telephone_number": "307-672-1100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIDENER",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-03-10",
"last_updated": "2021-05-24",
"certification_date": "2021-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA53799",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WY",
"license": "511",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mwidener@sjmc.cernerdirect.com",
"affiliation": "N",
"endpointDescription": "Direct Messaging Address for St John's Health",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Other",
"address_1": "3345 W Cody Lane Unit 9",
"city": "Teton Village",
"state": "WY",
"country_code": "US",
"postal_code": "83025",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mwidener@sheridan.cernerdirect.com",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CCDA",
"address_1": "1401 W 5th St",
"city": "Sheridan",
"state": "WY",
"country_code": "US",
"postal_code": "828012705",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Gillette, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.