MICHAEL C WIDMER (NPI# 1124092051) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124092051 |
| Entity Type | Individual |
| Full Name | MICHAEL C WIDMER |
| Credential | M.D |
| Practice Address |
929 Sw Simpson Ave Ste 300 Bend OR 97702 |
| Mailing Address |
Po Box 670 Bend OR 97709-0670 |
| Practice Telephone | 5413897741 |
| Practice Fax Number | 5412788375 |
| Mailing Telephone | 5413897741 |
| Mailing Fax Number | 5412788375 |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2019-08-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | MD22936 | OR | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
MD22936 | OR | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
MD22936 | OR | Allopathic & Osteopathic Physicians |
| N | 207UN0901X |
Nuclear Medicine Specialization: Nuclear Cardiology |
MD22936 | OR | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | RAIL ROAD MEDICARE | P00083868 | 01 |
| OR | 150842 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2500 Ne Neff Rd, Bend, OR 977016015 | 5413881636 | 5413881719 |
| Street Address |
929 SW SIMPSON AVE STE 300 |
| City | BEND |
| State | OR |
| Zip Code | 97702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538666268 | Eric Luther Sorenson | Physician Assistant | 929 Sw Simpson Ave Ste 300, Bend, OR 97702-3599 | 2018-04-10 |
| 1407296361 | Ashley Mcclary | Obstetrics & Gynecology | 929 Sw Simpson Ave Ste 300, Bend, OR 97702-3599 | 2013-06-25 |
| 1013296490 | Marie Casselberry Agnew | Nurse Practitioner | 929 Sw Simpson Ave Ste 300, Bend, OR 97702-3599 | 2011-08-16 |
| 1740578194 | Kelly Noelle Eilert | Counselor | 929 Sw Simpson Ave Ste 300, Bend, OR 97702 | 2011-07-19 |
| 1720251291 | Monica Ellen Rau Ramsey | Internal Medicine | 929 Sw Simpson Ave Ste 300, Bend, OR 97702-3599 | 2008-04-07 |
| 1861673667 | John Patrick Ramsey | Internal Medicine | 929 Sw Simpson Ave Ste 300, Bend, OR 97702 | 2007-11-20 |
| 1699827840 | Jason Prinster | Psychologist | 929 Sw Simpson Ave Ste 300, Bend, OR 97702 | 2007-01-17 |
| 1841228228 | Gary Allen Levinson | Psychiatry & Neurology | 929 Sw Simpson Ave Ste 300, Bend, OR 97702 | 2006-06-28 |
| 1568438836 | Ann Bridget Bird | Obstetrics & Gynecology | 929 Sw Simpson Ave Ste 300, Bend, OR 97702-3599 | 2006-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629676259 | Amy Michelle Anderson | Counselor | 233 Sw Wilson Ave, Ste 201, Bend, OR 97702 | 2020-10-15 |
| 1386259463 | Jacob Rehder | Counselor | 19717 Mt Batchelor Dr, #226, Bend, OR 97702 | 2020-09-15 |
| 1497385215 | Capacity Performance Therapy | Physical Medicine & Rehabilitation | 61125 Lodgepole Dr., Bend, OR 97702 | 2020-01-21 |
| 1962041707 | Shift Bend Functional Medicine | Family Medicine | 151 Sw Shevlin Hicks Dr, Suite #1, Bend, OR 97702 | 2019-12-26 |
| 1609435049 | Praxis Medical Group Inc | Orthopaedic Surgery | 1140 Sw Simpson Avenue, Suite 100, Bend, OR 97702 | 2019-06-10 |
| 1013485754 | Elana Leah Pesah | Social Worker | 138 Maaglei Harim Levin, Jerusalem, ISRAEL 97702 | 2018-11-12 |
| 1104303239 | Kyleigh Mcvey | Massage Therapist | 999 Sw Disk Dr, Bend, OR 97702 | 2018-07-21 |
| 1477042869 | Siloe Castaneda Huerta | Counselor | 1340 Nw Wall, Bend, Or, Bend, OR 97702 | 2018-05-02 |
| 1164910808 | Rebecca M Joyce | Social Worker | 1011 Sw Emkay Dr. Suite 101, Bend, OR 97702 | 2018-04-27 |
| 1093217978 | Jennifer Bury | Acupuncturist | 296 Sw Columbia St Ste D1, Bend, OR 97702 | 2018-03-06 |
| Find all providers in zip 97702 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114425493 | Cardiac Cin of Oregon LLC | Internal Medicine | 1867 Williams Hwy Ste 289, Grants Pass, OR 97527-5854 | 2018-01-31 |
| 1477994101 | Sena Kilic | Internal Medicine | 3181 Sw Sam Jackson Park Rd Fl Uhn622, Portland, OR 97239-3011 | 2013-07-10 |
| 1255455929 | Cameron A. Ramsay | Internal Medicine | 19250 Sw 65th Ave Ste 265, Tualatin, OR 97062-7747 | 2007-03-19 |
| 1114081700 | George Kubac | Internal Medicine | 2614 Clover St, Klamath Falls, OR 97601-1132 | 2006-12-20 |
| 1215978671 | Roger J. Dreiling | Internal Medicine | 1698 E Mcandrews Rd Ste 300, Medford, OR 97504-5590 | 2006-06-09 |
| 1437111507 | Northwest Cardiologists, P.C. | Internal Medicine | 333 Se 7th Ave, Suite 5200, Hillsboro, OR 97123-4157 | 2006-04-04 |
| 1114923760 | Vincent P Reyes | Internal Medicine | 349 Se 7th Ave, Hillsboro, OR 97123-4112 | 2005-06-27 |
| 1588126650 | Cor Care of Or, LLC | Internal Medicine | 1867 Williams Hwy Ste 289, Grants Pass, OR 97527-5854 | 2019-04-05 |
| 1467719641 | Ross Vimr | Internal Medicine | 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 | 2012-04-12 |
| 1932499373 | Deepika Narasimha | Internal Medicine | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471-2348 | 2011-04-18 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.