Individual provider Active NPI

Janet May Widmyer

  • Registered Nurse
  • Ketchikan, AK
National Provider Identifier
1811185275
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
24429 Issued in AK
Practice address
2960 Tongass Aveune
Suite 403
Ketchikan, AK 99901
Phone
(907) 228-4902
Fax
(907) 228-5256
NPI assigned
Oct 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 24429 AK Primary

Addresses

Primary practice location

2960 Tongass Aveune
Suite 403
Ketchikan, AK 99901

Mailing address

2960 Tongass Ave
Suite 403
Ketchikan, AK 99901-5742
Phone (907) 228-4902

Other identifiers 1

IdentifierTypeStateIssuer
24429OtherAKSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
24429AKMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192060800000",
    "number": "1811185275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 TONGASS AVE",
            "address_2": "SUITE 403",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "999015742",
            "telephone_number": "907-228-4902",
            "fax_number": "907-228-5256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 TONGASS AVEUNE",
            "address_2": "SUITE 403",
            "city": "KETCHIKAN",
            "state": "AK",
            "postal_code": "99901",
            "telephone_number": "907-228-4902",
            "fax_number": "907-228-5256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDMYER",
        "first_name": "JANET",
        "middle_name": "MAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "24429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "24429",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ketchikan, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.