Angela Marie Wideman, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2008031373 Issued in MO

Practice address

2675 Court Drive
Gastonia, NC 28054-1478

Phone

(704) 824-4999

NPI assigned

Mar 24, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Move & Play LLC

  • Physical Therapy Clinic/Center
  • Huntersville, NC
  • NPI 1831851609
  NPD
• BDM Associates LLC

  • Physical Therapist
  • Columbia, MO
  • NPI 1801847033
  NPD (past)

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294272000000",
    "number": "1831331735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16927 BIRKDALE COMMONS PKWY",
            "address_2": "APT. D",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280784884",
            "telephone_number": "314-952-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 COURT DRIVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280541478",
            "telephone_number": "704-824-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDEMAN",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-24",
        "last_updated": "2011-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2008031373",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MO",
            "license": "2008031373",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paula Faith Whitley
• Yvette Michelle Whitley, LCSWA
• Victoria Whittaker
• Rosaline Relena Whittington
• Terrilyn Ashunti Wicker
• Jordan Widenhouse
• Kia Wiggins, MSW, LCSW
• Sam Wilcox II, M.D.
• Lashe' Wilder
• Teresa V. Wiles, PT

• Physical Therapist in Gastonia, NC
• Providers in Gastonia, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2011; 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.