Paul E Widmayer, MSRD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

913170 Issued in AZ

Practice address

6439 Garners Ferry Rd
Columbia, SC 29209-1638

Phone

(803) 776-4000

Fax

(803) 695-7978

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851310775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 HALLBROOK DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292094710",
            "telephone_number": "803-647-1477",
            "fax_number": "803-695-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6439 GARNERS FERRY RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091638",
            "telephone_number": "803-776-4000",
            "fax_number": "803-695-7978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDMAYER",
        "first_name": "PAUL",
        "middle_name": "E",
        "credential": "MSRD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AZ",
            "license": "913170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin L Wickes, PH.D.
• David Lee Wickstrom, PSYCHOLOGIST
• Colin English Widener, MD
• Michelle Widener, M.D.
• Rebecca W Widener, MD.
• Anna K Wiegner, FNP-BC
• Matthew M Wienecke, MD
• Benjamin Thomas Wietecha, DMD
• Scott C Wietecha, DMD
• Billy W. Wiggins, RN

• Registered Dietitian in Columbia, SC
• Providers in Columbia, SC by specialty
• Registered Dietitian in South Carolina

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