Victor R Widner, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

ME25939 Issued in FL

Practice address

4800 Belfort Rd
Second Floor
Jacksonville, FL 32256-6004

Phone

(904) 398-7205

Fax

(904) 396-4047

NPI assigned

Aug 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• BGC Holdings Inc

  • Ambulatory Surgical Clinic/Center
  • Jacksonville, FL
  • NPI 1588633481
  NPD (past)
• Jax Anesthesia Providers LLC

  • Anesthesiology Physician
  • Jacksonville, FL
  • NPI 1245271154
  NPD (past)

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1912990284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004",
            "telephone_number": "904-398-3262",
            "fax_number": "904-265-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 BELFORT RD",
            "address_2": "SECOND FLOOR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566004",
            "telephone_number": "904-398-7205",
            "fax_number": "904-396-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDNER",
        "first_name": "VICTOR",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-23",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME25939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "040537000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natavia M Wicker, OTA
• Brian Wickers
• Johnnetta Nicole Wider, RN
• John Widergren
• Kathryn Michelle Widmer
• Jason Brian Widrich, MD
• Christina Stockwell Wieczorek, M.D.
• Tammy Alvarez Wiedeman, RD, LD,N
• Russell Frederick Wiegand, PHARMD
• Layton Wiemer

• Gastroenterology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Gastroenterology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.