Organization Active NPI

Robert R. Witham, MD. Inc,PS

  • Internal Medicine Physician
  • Port Angeles, WA
National Provider Identifier
1023361367
Registry record updated Oct 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
ROBERT R. WITHAM, MD. INC,PS
Practice address
224 N Washington St
Port Angeles, WA 98362-3908
Phone
(360) 452-5322
Fax
(360) 452-5236
NPI assigned
Oct 24, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2012

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

Authorized official

Name
Cathy Vanos
Title
Biller
Phone
(360) 452-5322

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

224 N Washington St
Port Angeles, WA 98362-3908

Mailing address

224 N Washington St
Port Angeles, WA 98362-3908
Phone (360) 452-5322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121128000040 WA Part B Supplier - Clinic/Group Practice 4688825573 Receives reassigned benefits from 1 practitioner
Practice locations: Olympia, WA; Port Angeles, WA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351036800000",
    "number": "1023361367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 N WASHINGTON ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623908",
            "telephone_number": "360-452-5322",
            "fax_number": "360-452-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 N WASHINGTON ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623908",
            "telephone_number": "360-452-5322",
            "fax_number": "360-452-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT R. WITHAM, MD. INC,PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-24",
        "last_updated": "2012-10-24",
        "status": "A",
        "authorized_official_last_name": "VANOS",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "BILLER",
        "authorized_official_telephone_number": "360-452-5322"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Angeles, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.