Michelle Nancy Widholm, PHARM.D

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0202215003 Issued in VA

Practice address

2400 E Main St
Richmond, VA 23223-7846

Phone

(804) 643-1383

Fax

(804) 643-1388

NPI assigned

Nov 25, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Virginia CVS Pharmacy, L.L.C.

  • Pharmacy
  • Sterling, VA
  • NPI 1689558371
  NPD (past)
• Virginia CVS Pharmacy, L.L.C.

  • Pharmacy
  • Richmond, VA
  • NPI 1770687444
  NPD (past)

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

{
    "created_epoch": "1606262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684195200000",
    "number": "1598369902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 E MAIN ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232237846",
            "telephone_number": "804-643-1383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 E MAIN ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232237846",
            "telephone_number": "804-643-1383",
            "fax_number": "804-643-1388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDHOLM",
        "first_name": "MICHELLE",
        "middle_name": "NANCY",
        "name_prefix": "Dr.",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-25",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "VA",
            "license": "0202215003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracylynn Huntley Wickham, LCSW
• Carey Lynn Wickizer, OTR/L
• Kyle Allen Wickliff
• Samantha Wickman, MD
• Haley Wideman, MOT
• Kathryn Helen Wie, MD
• Steven M Wiebe-King, M.D.
• Elizabeth G Wiebe, FNP
• Kempton Mathias Wiebe
• Darrin Michael Wiederhold, DMD MS

• Community/Retail Pharmacy in Richmond, VA
• Providers in Richmond, VA by specialty
• Community/Retail Pharmacy in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.