Individual provider Active NPI

Christen Wiedower, FNP

  • Primary Care Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1851907703
Registry record updated Jul 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
28212 Issued in TN
Practice address
7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone
(901) 683-0055
NPI assigned
Sep 16, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 904140 MS
Primary Care Nurse Practitioner 363LP2300X 28212 TN Primary

Addresses

Primary practice location

7945 Wolf River Blvd
Germantown, TN 38138-1762

Mailing address

7945 Wolf River Blvd
Germantown, TN 38138-1762
Phone (901) 683-0055

Other identifiers 1

IdentifierTypeStateIssuer
NAOtherNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Cwiedower@westclinic.com

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
904140MSMDFamily Nurse Practitioner
28212TNMDPrimary Care Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: cwiedower23898@mlh.direct-ci.com

NPI Registry JSON

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657843200000",
    "number": "1851907703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7945 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381762",
            "telephone_number": "901-683-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7945 WOLF RIVER BLVD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381762",
            "telephone_number": "901-683-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDOWER",
        "first_name": "CHRISTEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2022-07-15",
        "certification_date": "2022-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904140",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "28212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NA",
            "identifier": "NA",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Cwiedower@westclinic.com",
            "affiliation": "N",
            "address_1": "7945 Wolf River Blvd",
            "city": "Germantown",
            "state": "TN",
            "country_code": "US",
            "postal_code": "381381762",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2022; 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.