Vanessa K Wideman, MD is a medicare enrolled "Family Medicine" physician in Eastover, South Carolina. Her current practice location is
1325 S Carolina Rd Ste 11, Eastover, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(803) 647-8295.
Vanessa K Wideman is licensed to practice in South Carolina (license number 29480) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1982691796.
Physician's Profile
Full Name | Vanessa K Wideman |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 1325 S Carolina Rd Ste 11, Eastover, South Carolina |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1982691796
- Provider Enumeration Date: 10/06/2005
- Last Update Date: 07/17/2018
Medicare PECOS Information:
- PECOS PAC ID: 8729186580
- Enrollment ID: I20070604000079
Medical Identifiers
Medical identifiers for Vanessa K Wideman such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1982691796 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 29480 (South Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Vanessa K Wideman allows following entities to bill medicare on her behalf.
Entity Name | Signify Health Medical Associates Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20191209002986 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Vanessa K Wideman is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Vanessa K Wideman, MD 1325 S Carolina Rd Ste 11, Eastover, SC 29044-5000 Ph: (803) 647-8295 | Vanessa K Wideman, MD 1325 S Carolina Rd Ste 11, Eastover, SC 29044 Ph: (803) 647-8295 |
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