Jeanne Ray Wiedemann, NNP-BC

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

AP2464 Issued in AZ

Practice address

7720 N 16TH St
Ste 425
Phoenix, AZ 85020-4492

Phone

(602) 476-8962

Fax

(623) 643-9236

NPI assigned

Nov 2, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Banner-University Medical Group

  • Multi-Specialty Clinic/Center
  • Phoenix, AZ
  • NPI 1508809427
  Medicare reassignment NPD
• Sierra Vista Regional Health Center Medical Group LLC

  • Family Medicine Physician
  • Sierra Vista, AZ
  • NPI 1043575483
  Medicare reassignment NPD
• Banner-University Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Tucson, AZ
  • NPI 1922820935
  NPD
• Obstetrix Medical Group of Phoenix PC

  • Neonatal-Perinatal Medicine Physician
  • Mesa, AZ
  • NPI 1407957152
  NPD (past)

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

{
    "created_epoch": "1257120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789171200000",
    "number": "1861728495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7720 N 16TH ST",
            "address_2": "STE 425",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204492",
            "telephone_number": "602-476-8962",
            "fax_number": "623-643-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7720 N 16TH ST",
            "address_2": "STE 425",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204492",
            "telephone_number": "602-476-8962",
            "fax_number": "623-643-9236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDEMANN",
        "first_name": "JEANNE",
        "middle_name": "RAY",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-11-02",
        "last_updated": "2026-09-12",
        "certification_date": "2026-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "CO",
            "license": "C-APN-0107560-C-NP",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "AZ",
            "license": "AP2464",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN080027",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "575555",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dayna Alison Widoff, M.S.
• Christopher Sung Wie, MD
• Jordan Wiebe, DO
• Robert J Wiebers, APN
• Tana Wiebers
• Nicholas Ryan Wieferich, PHARMD
• Aaron Lawrence Wiegand, D.C.
• Brianne Wiens
• Gayle A Wiens, RPT
• Katelyn Richelle Wierenga, LCSW

• Neonatal Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Neonatal Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.