Peter Widhalm, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

1184 Issued in NE

Practice address

2900 F St
Omaha, NE 68107-1533

Phone

(402) 731-7990

NPI assigned

Dec 27, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1689180770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 MARTHA ST APT 11E",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681053168",
            "telephone_number": "631-871-2593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 F ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071533",
            "telephone_number": "402-731-7990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Martha St. 11E",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681056810",
            "country_code": "US",
            "telephone_number": "631-871-2593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WIDHALM",
        "first_name": "PETER",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NE",
            "license": "1184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeff Wickwire
• Kevin M Wickwire
• Matthew Wickwire
• Cassandra Widener, M.S., OTR/L
• Conrad Widener
• Ryan Widhalm
• Kylie Widhelm Lynn Widhelm, OTD, OTR/L, BCPR
• Kelsey Ann Widlund
• Amber J Widstrom, PA
• Jamie Lyn Wiebelhaus, RN

• Physical Therapy Assistant in Omaha, NE
• Providers in Omaha, NE by specialty
• Physical Therapy Assistant in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.