Mackenzie Widmaier, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

RN708029 Issued in PA

Practice address

100 N Academy Ave
Danville, PA 17822-9800

Phone

(570) 271-6621

Fax

(570) 271-6762

NPI assigned

Mar 28, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mackenzie Clark Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2026

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Geisinger ClinicGroup PAC ID 5395657001, shared by 7 NPIs, 3,432 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786665600000",
    "number": "1558112409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178224903",
            "telephone_number": "570-271-6621",
            "fax_number": "570-271-6762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178229800",
            "telephone_number": "570-271-6621",
            "fax_number": "570-271-6762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDMAIER",
        "first_name": "MACKENZIE",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2026-08-14",
        "certification_date": "2026-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN708029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "CLARK",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Whitmire, R.D.
• Holly Lynn Whitner, PHARMD
• Jacob Whitney
• Thomas R. Wickham, PA-C
• James C. Widmaier Jr., M.D.
• Kenneth A. Widom, M.D.
• Donald Wieder, PA-C
• Karen Wiesen, MS, RDN, LDN
• Aubrey Ann Wiesner, PA-C
• Megan Wijesinghe

• Certified Registered Nurse Anesthetist in Danville, PA
• Providers in Danville, PA by specialty
• Certified Registered Nurse Anesthetist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.

Verify at the official NPI Registry.