Jonathan Robert Widmeyer, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

LL92610 Issued in SC

Practice address

171 Ashley Ave
Charleston, SC 29425-0100

Phone

(434) 941-9856

NPI assigned

Jun 29, 2024

Last updated

Jun 29, 2024By the provider in NPPES

Sex

Male

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 SC

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

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

{
    "created_epoch": "1719619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719619200000",
    "number": "1629813761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 ASHLEY AVE RM 202",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294250100",
            "telephone_number": "434-941-9856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDMEYER",
        "first_name": "JONATHAN",
        "middle_name": "ROBERT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-29",
        "last_updated": "2024-06-29",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "SC",
            "license": "LL92610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Miranda Whitson, RN
• Benjamin Howard Whitt
• Rebecca J Whitt, LPC
• David Allen Whittaker, DMD
• Stephen Paul Wicker, DO
• Madeline Marie Wiechec, PA-C
• Wiedrich LLC (HealthSource of James Island)
• John Russell Wieser, MD
• Ashley Wietor, M.A., LPC
• Barbara S Wiggins, PHARM.D.,

• Orthopaedic Surgery Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Orthopaedic Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2024; 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.