Eleanor A Widdice, MD

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

35088202 Issued in OH

Practice address

3333 Burnet Avenue
ML 4000
Cincinnati, OH 45229

Phone

(513) 636-3336

Fax

(513) 636-8844

NPI assigned

Jul 10, 2006

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Children's Hospital Medical Center

  dba Cincinnati Children's Hospital Medical Center

  • Pediatrics Physician
  • Cincinnati, OH
  • NPI 1609915784
  Medicare reassignment NPD

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578597985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "ML 5021",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45229",
            "telephone_number": "513-636-5013",
            "fax_number": "866-213-7084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVENUE",
            "address_2": "ML 4000",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45229",
            "telephone_number": "513-636-3336",
            "fax_number": "513-636-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDICE",
        "first_name": "ELEANOR",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "OH",
            "license": "35088202",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allen Wicken, P.T.
• Charles Wickenhofer, LSW
• Brodus Lee Wicks
• Wickshire Deer Park Opco LLC
• Matt Widanski, PHARMD
• Michelle L Widecan, CNP
• Kristie Ann Wideen, COTA/L
• Jennifer Widener
• Elysa Widjaja, MD
• Cindy Jean Widmyer, NNP

• Pediatric Adolescent Medicine Physician in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Pediatric Adolescent Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.