Joan T Wildenhain, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN225095 Issued in MA

Practice address

479 Swansea Mall Dr
Swansea, MA 02777-4119

Phone

(508) 973-1550

Fax

(508) 973-0386

NPI assigned

Sep 19, 2005

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in RI, MA2 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

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwildenhain20672@direct.southcoast.org

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.

• Southcoast Physicians Group, Inc.

  • Family Medicine Physician
  • Fairhaven, MA
  • NPI 1336137629

  RI

  Medicare reassignment Care Compare group NPD
• Southcoast Physicians Group, Inc.

  • Orthopaedic Surgery Physician
  • North Dartmouth, MA
  • NPI 1902201536
  NPD

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

• Southcoast Hospitals Group, Inc

  • General Acute Care Hospital
  • Wareham, MA
  • NPI 1922024835
  Care Compare affiliation

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725753600000",
    "number": "1720073455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "address_2": "SUITE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 SWANSEA MALL DR",
            "city": "SWANSEA",
            "state": "MA",
            "postal_code": "027774119",
            "telephone_number": "508-973-1550",
            "fax_number": "508-973-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDENHAIN",
        "first_name": "JOAN",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2024-09-08",
        "certification_date": "2024-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN225095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110105942A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwildenhain20672@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "479 Swansea Mall Dr",
            "city": "Swansea",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027774119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Christine Marie Wirges
• Hugh Woolverton III, M.D.
• Yellow Brick Physical Therapy LLC

• Nurse Practitioner in Swansea, MA
• Providers in Swansea, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 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.
• 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.