NPIMap

Individual provider Active NPI

Tricia Lynn Widlund, A.R.N.P.

  • Family Nurse Practitioner
  • Fort Dodge, IA
National Provider Identifier
1790087013
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A093647 Issued in IA
Practice address
119 Avenue O W
Fort Dodge, IA 50501-5634
Phone
(515) 955-9200
Fax
(515) 955-9201
NPI assigned
Nov 18, 2010
Last updated
Mar 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A093647 IA Primary

Addresses

Primary practice location

119 Avenue O W
Fort Dodge, IA 50501-5634

Mailing address

PO Box 430
Webster City, IA 50595-0430
Phone (515) 955-9200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address twidl@vdmc.cernerdirect.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110125000422 IA Practitioner - Nurse Practitioner 7618156522 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices
Hamilton County Public HospitalGroup PAC ID 1254241565, shared by 6 NPIs, 33 clinicians

Practice addresses (Care Compare)

2350 Hospital Dr
Webster City, IA 50595-6600
Phone (515) 832-9400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A093647IAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton County Public Hospital CurrentSince Jul 1, 2020 Accepting new patients
Hamilton County Public Hospital Current Accepting new patients
Hamilton County Public Hospital Current Accepting new patients
Hamilton County Public Hospital CurrentSince Jul 1, 2020 Accepting new patients

Locations

119 Avenue O W
Fort Dodge, IA 50501
Phone (515) 955-9200

Interoperability endpoints

  • Direct secure messaging: twidl@vdmc.cernerdirect.com

Organizations & group practices 4

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1790087013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 430",
            "city": "WEBSTER CITY",
            "state": "IA",
            "postal_code": "505950430",
            "telephone_number": "515-955-9200",
            "fax_number": "515-955-9201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 AVENUE O W",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015634",
            "telephone_number": "515-955-9200",
            "fax_number": "515-955-9201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDLUND",
        "first_name": "TRICIA",
        "middle_name": "LYNN",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-18",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A093647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "twidl@vdmc.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Van Diest Family Health Clinic of Fort Dodge",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "119 Avenue O W",
            "city": "Fort Dodge",
            "state": "IA",
            "country_code": "US",
            "postal_code": "505015634",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

Verify at the official NPI Registry.