Carrie Renee Widener, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26733 Issued in TN

Practice address

1 Medical Park Blvd Ste 300E
Bristol, TN 37620-7497

Phone

(423) 844-6450

NPI assigned

Oct 25, 2019

Last updated

Apr 3, 2020By the provider in NPPES

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 TN, VA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

East Tennessee State University Quillen College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellmont Bristol Regional Medical Center Hospital, Bristol, TN, CCN 440012

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carrie.widener.1@1054.direct.athenahealth.com
• Direct secure messaging: carrie.widener.1@1366.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4

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.

• Campbell Clinic, PC

  • Orthopaedic Surgery Physician
  • Germantown, TN
  • NPI 1003835141
  Medicare reassignment Care Compare group NPD
• Appalachian Orthopaedic Associates P C

  dba Appalachian Orthopedics Associates, PC

  • Orthopaedic Surgery Physician
  • Rogersville, TN
  • NPI 1063875649
  Medicare reassignment NPD
• Appalachian Orthopaedic Associates P C

  • Orthopaedic Surgery Physician
  • Norton, VA
  • NPI 1831495613
  Medicare reassignment NPD
• Appalachian Orthopaedic Associates P C

  • Orthopaedic Surgery Physician
  • Bristol, TN
  • NPI 1639108822
  NPD
• Appalachian Orthopaedic Associates P C

  • Orthopaedic Surgery Physician
  • Kingsport, TN
  • NPI 1669940078
  NPD
• Campbell Clinic PC

  • Durable Medical Equipment & Medical Supplies
  • Carthage, TN
  • NPI 1669366068
  NPD
• Appalachian Orthopaedic Associates, PC

  • Orthopaedic Surgery Physician
  • Kingsport, TN
  • NPI 1598703043
  NPD (past)
• Campbell Clinic

  dba Campbell Clinic MRI

  • Magnetic Resonance Imaging (MRI) Clinic/Center
  • Germantown, TN
  • NPI 1588619944
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Wellmont Health System

  dba Bristol Regional Medical Center

  • General Acute Care Hospital
  • Bristol, TN
  • NPI 1124058615
  Care Compare affiliation

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

{
    "created_epoch": "1571961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1649813346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD STE 300E",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207497",
            "telephone_number": "423-844-6450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL PARK BLVD STE 300E",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376207497",
            "telephone_number": "423-844-6450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDENER",
        "first_name": "CARRIE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-25",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keith Anthony White, M.D.
• Laura White
• Taylor White, ATC
• Sharon Lee Whitman, CRNA
• Thomas Lisle Whitman, M.D.
• Caleb Odum Widner, DDS
• Savannah Noel Wiley, LMSW
• Kenan Treh Wilhoit, MD
• William J. Schermer PLLC
• Douglas Paul Williams, MD

• Family Nurse Practitioner in Bristol, TN
• Providers in Bristol, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; 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.
• 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.

Verify at the official NPI Registry.