Active NPI
Jessica Tompkins Wieduwilt, CRNA
- Certified Registered Nurse Anesthetist
- Oklahoma City, OK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 202035
- Practice address
- 920 Stanton L Young Blvd
Oklahoma City, OK 73104-5036 - Phone
- (405) 271-4351
- Fax
- (405) 271-8695
- NPI assigned
- Nov 20, 2009
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 202035 | OK | Primary |
| Registered Nurse | 163W00000X | 688535 | CA | |
| Certified Registered Nurse Anesthetist | 367500000X | 3885 | CA |
Addresses
Primary practice location
920 Stanton L Young Blvd
Oklahoma City, OK 73104-5036
Mailing address
PO Box 26901
Oklahoma City, OK 73126-0901
Phone (405) 271-4351
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, NC
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 99.15 of 100
- Promoting interoperability
- 99
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7057 | NC | MD | Pharmacist |
| 202035 | OK | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current | Accepting new patients |
Locations
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
-
- Certified Registered Nurse Anesthetist
- San Diego, CA
- NPI 1265535702
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Psychiatric Hospital Unit
- Winston Salem, NC
- NPI 1063480531
-
- Rehabilitation Hospital Unit
- Winston Salem, NC
- NPI 1114995677
-
dba Wake Forest Baptist Medical Center
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1144211301
-
dba Wake Forest Baptist Medical Center
- Clinical Medical Laboratory
- Winston Salem, NC
- NPI 1609162098
Hospital
-
dba Winston East Pediatrics
- Pediatric Adolescent Medicine Physician
- Winston Salem, NC
- NPI 1912179219
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643328000000",
"number": "1558699090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26901",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731260901",
"telephone_number": "405-271-4351",
"fax_number": "405-271-8695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "920 STANTON L YOUNG BLVD",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731045036",
"telephone_number": "405-271-4351",
"fax_number": "405-271-8695"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEDUWILT",
"first_name": "JESSICA",
"middle_name": "TOMPKINS",
"name_prefix": "Mrs.",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-11-20",
"last_updated": "2022-01-28",
"certification_date": "2022-01-28",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "OK",
"license": "202035",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "688535",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CA",
"license": "3885",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.