Active NPI
Mary Therese Sorensen Wiederhold
- Primary Care Nurse Practitioner
- Maumee, OH
National Provider Identifier
1598683021
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Nurse Practitioner
- License
- APRN.CNP.0042672
- Practice address
- 805 Askin St
Maumee, OH 43537-3603 - Phone
- (419) 704-0383
- NPI assigned
- Jul 10, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | APRN.CNP.0042672 | OH | Primary |
Addresses
Primary practice location
805 Askin St
Maumee, OH 43537-3603
Mailing address
805 Askin St
Maumee, OH 43537-3603
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1783641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783641600000",
"number": "1598683021",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 ASKIN ST",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435373603"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 ASKIN ST",
"city": "MAUMEE",
"state": "OH",
"postal_code": "435373603",
"telephone_number": "419-704-0383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SORENSEN WIEDERHOLD",
"first_name": "MARY",
"middle_name": "THERESE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-07-10",
"last_updated": "2026-07-10",
"certification_date": "2026-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "363LP2300X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Primary Care",
"state": "OH",
"license": "APRN.CNP.0042672",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maumee, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; 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.