Marnie Jean Widdifield, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01051575A Issued in IN

Practice address

1542 S Bloomington St
Greencastle, IN 46135-2297

Phone

(765) 301-7617

Fax

(765) 301-7621

NPI assigned

Jan 31, 2006

Last updated

Mar 31, 2021By 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

Other identifiers 6

Other names 1

• Miss Marnie Jean Dornhecker Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

97

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Indiana Emergency Professionals PC

  • Emergency Medicine Physician
  • Lawrenceburg, IN
  • NPI 1598068017
  Medicare reassignment NPD
• Putnam County Hospital

  • Critical Access Hospital
  • Greencastle, IN
  • NPI 1578608188
  Medicare reassignment NPD
• Putnam County Hospital

  • Critical Access Hospital
  • Greencastle, IN
  • NPI 1912947490
  Medicare reassignment NPD
• Putnam County Hospital

  dba Putnam Prompt Care

  • Rural Health Clinic/Center
  • Greencastle, IN
  • NPI 1295972412
  NPD
• Community Health Network, Inc

  dba Community Behavioral Professionals

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Indianapolis, IN
  • NPI 1922336262
  NPD (past)
• Community Hospitals of Indiana Inc

  dba Marnie Widdifield MD

  • Family Medicine Physician
  • Greenwood, IN
  • NPI 1689692501
  NPD (past)
• Southside Emergency Associates

  • Personal Emergency Response Attendant
  • Indianapolis, IN
  • NPI 1053366922
  NPD (past)

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1790756443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 E COUNTY LINE RD",
            "address_2": "SUITE A",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431067",
            "telephone_number": "317-497-6180",
            "fax_number": "317-497-6184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 S BLOOMINGTON ST",
            "city": "GREENCASTLE",
            "state": "IN",
            "postal_code": "461352297",
            "telephone_number": "765-301-7617",
            "fax_number": "765-301-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDIFIELD",
        "first_name": "MARNIE",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01051575A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MPLAN (PROHEALTH)",
            "identifier": "000000001373",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "000000336833",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROHEALTH",
            "identifier": "510512209",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL INSURANCE",
            "identifier": "510512209",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPEN",
            "identifier": "510512209",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00201816",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ehr-direct@pchosp.hin.us",
            "affiliation": "N",
            "address_1": "1542 S Bloomington St",
            "city": "Greencastle",
            "state": "IN",
            "country_code": "US",
            "postal_code": "461352297",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MARNIE",
            "last_name": "DORNHECKER",
            "middle_name": "JEAN",
            "prefix": "MISS",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wal-Mart Stores East, LP (Vision Center 30-0902)
• Amy Walls, MSW
• Watt Family Medical and Medical Aesthetics, LLC
• Christy Jo Webb, NRP
• Lacy Wells, MSW
• Brian Williams, PHARMD
• Esther L. Wilson, RN, FNP
• Gerald Wilson, DPT
• Paul Thomas Wilson, LMHC, LMFT, LSW
• Rebecca Lynn Wilson

• Family Medicine Physician in Greencastle, IN
• Providers in Greencastle, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.