Nicholas Paul Wittwer, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7604350-1206 Issued in UT

Practice address

2825 E Mall Dr
St George, UT 84790-1954

Phone

(435) 251-0400

Fax

(435) 251-0401

NPI assigned

Aug 28, 2013

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

Electronic endpoints 5

Medicare fee-for-service enrollment

Enrolled in UT, NV2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. George Regional Hospital Hospital, St George, UT, CCN 460021
• Intermountain Health Cedar City Hospital Hospital, Cedar City, UT, CCN 460007

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group
• Physician Group of Utah Inc

  • Specialist
  • South Jordan, UT
  • NPI 1477676930
  Medicare reassignment NPD
• Revere Health PC

  dba Revere Health

  • Multi-Specialty Clinic/Center
  • Provo, UT
  • NPI 1093764805

  NV

  Medicare reassignment NPD
• Tanner Memorial Clinic

  • Internal Medicine Physician
  • Layton, UT
  • NPI 1447239355
  Medicare reassignment
• Ihc Health Services Inc

  dba St George Anticoagulation

  • Clinic/Center
  • St George, UT
  • NPI 1629721725
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Revere Health PC

  dba Revere Health

  • Multi-Specialty Clinic/Center
  • Spanish Fork, UT
  • NPI 1851142285
  NPD
• Tanner Memorial Clinic

  dba Tanner Clinic

  • Primary Care Clinic/Center
  • Farmington, UT
  • NPI 1447845730
  NPD
• Tanner Memorial Clinic

  dba Tanner Clinic Layton South

  • Multi-Specialty Clinic/Center
  • Layton, UT
  • NPI 1538951165
  NPD
• Ihc Health Services Inc

  dba Orem Community Hospital Physicians

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services, Inc.

  dba Intermountain Health St. George Regional Hospital

  • General Acute Care Hospital
  • St George, UT
  • NPI 1366452880
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health Cedar City Hospital

  • General Acute Care Hospital
  • Cedar City, UT
  • NPI 1538178801
  Care Compare affiliation

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

{
    "created_epoch": "1377648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1013341965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 NORTH 500 WEST",
            "address_2": "ATTN: CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2825 E MALL DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847901954",
            "telephone_number": "435-251-0400",
            "fax_number": "435-251-0401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "355 N Main St",
            "address_purpose": "LOCATION",
            "city": "Kanab",
            "state": "UT",
            "postal_code": "847413260",
            "country_code": "US",
            "telephone_number": "435-251-2900",
            "fax_number": "435-251-2901",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2121 N 1700 W",
            "address_purpose": "LOCATION",
            "city": "Layton",
            "state": "UT",
            "postal_code": "840418803",
            "country_code": "US",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1059 N 100 W",
            "address_purpose": "LOCATION",
            "city": "Beaver",
            "state": "UT",
            "postal_code": "847137758",
            "country_code": "US",
            "telephone_number": "435-383-9009",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Falcon Ridge Pkwy Ste 400A",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "NV",
            "postal_code": "890278881",
            "country_code": "US",
            "telephone_number": "435-251-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1320 N Main St",
            "address_purpose": "LOCATION",
            "city": "Cedar City",
            "state": "UT",
            "postal_code": "847211229",
            "country_code": "US",
            "telephone_number": "435-251-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1870 N Main St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Cedar City",
            "state": "UT",
            "postal_code": "847217742",
            "country_code": "US",
            "telephone_number": "435-383-9009",
            "fax_number": "435-383-9010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "350 Falcon Ridge Pkwy Ste 500",
            "address_purpose": "LOCATION",
            "city": "Mesquite",
            "state": "NV",
            "postal_code": "890278878",
            "country_code": "US",
            "telephone_number": "725-333-9026",
            "fax_number": "725-333-9027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITTWER",
        "first_name": "NICHOLAS",
        "middle_name": "PAUL",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-28",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "7604350-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "address_1": "355 N Main St",
            "city": "Kanab",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847413260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "address_1": "330 Falcon Ridge Pkwy Ste 400A",
            "city": "Mesquite",
            "state": "NV",
            "country_code": "US",
            "postal_code": "890278881",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "address_1": "1059 N 100 W",
            "city": "Beaver",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847137758",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Central Utah Clinic, P.C.",
            "address_1": "1320 N Main St",
            "city": "Cedar City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847211229",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "address_1": "2825 E Mall Dr",
            "city": "St George",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847901954",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wisdom Teeth of Southern Utah
• Lincoln Wise
• Cindi Witt, BCBA
• Emma Wittemund
• Lyla Rose Wittwer
• Christoph T Woerlein, MD
• Madison Wogksch
• Shonnie Wolcott
• Tayler Mychele Wolfe
• Annabella Kristine Wolfert

• Physician Assistant in St George, UT
• Providers in St George, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; 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.

Verify at the official NPI Registry.