Active NPI
Cynthia Ann Wildemuth, RNC MSN ARNP
- Obstetrics & Gynecology Nurse Practitioner
- Clinton, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner
- License
- F099435
- Practice address
- 2635 Lincoln Way Ste a
Clinton, IA 52732-7229 - Phone
- (563) 243-1413
- Fax
- (309) 558-2815
- NPI assigned
- Feb 7, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | 209.004796 | IL | |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | F099435 | IA | Primary |
Addresses
Primary practice location
2635 Lincoln Way Ste a
Clinton, IA 52732-7229
Mailing address
2635 Lincoln Way Ste a
Clinton, IA 52732-7229
Phone (563) 243-1413
Other practice location 1
2112 25th Avenue
Rock Island, IL 61201
Phone (309) 795-7088
Other practice location 2
229 S Main St
Maquoketa, IA 52060-3056
Phone (563) 652-3749
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891067765 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
229 S Main St
Maquoketa, IA 52060-3056
Phone (563) 652-3749
2635 Lincoln Way a
Clinton, IA 52732-7203
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F099435 | IA | MD | Obstetrics & Gynecology Nurse Practitioner |
| 209.004796 | IL | MD | Obstetrics & Gynecology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Womens Health Services of Eastern Iowa Inc | Current | Accepting new patients |
Locations
2635 Lincoln Way
Clinton, IA 52732
Phone (563) 243-1413
2635 Lincoln Way
Ste A
Clinton, IA 52732
Phone (563) 241-1328
229 S Main St
Maquoketa, IA 52060
Phone (563) 352-3749
Organizations & group practices 1
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.
-
- Non-Surgical Family Planning Clinic/Center
- Clinton, IA
- NPI 1720056492
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669593600000",
"number": "1891067765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2635 LINCOLN WAY STE A",
"city": "CLINTON",
"state": "IA",
"postal_code": "527327229",
"telephone_number": "563-243-1413",
"fax_number": "309-558-2815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2635 LINCOLN WAY STE A",
"city": "CLINTON",
"state": "IA",
"postal_code": "527327229",
"telephone_number": "563-243-1413",
"fax_number": "309-558-2815"
}
],
"practiceLocations": [
{
"address_1": "2112 25th Avenue",
"address_purpose": "LOCATION",
"city": "Rock Island",
"state": "IL",
"postal_code": "61201",
"country_code": "US",
"telephone_number": "309-795-7088",
"fax_number": "309-558-2815",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "229 S Main St",
"address_purpose": "LOCATION",
"city": "Maquoketa",
"state": "IA",
"postal_code": "520603056",
"country_code": "US",
"telephone_number": "563-652-3749",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILDEMUTH",
"first_name": "CYNTHIA",
"middle_name": "ANN",
"credential": "RNC MSN ARNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-07",
"last_updated": "2022-11-28",
"certification_date": "2022-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "IL",
"license": "209.004796",
"primary": false
},
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "IA",
"license": "F099435",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1891067765",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Clinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.