Active NPI
Kristopher Dewayne Witt, M.S. CCC-SLP
- Speech-Language Pathologist
- Tazewell, VA
National Provider Identifier
1033423660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202005778
- Practice address
- 121 Ben Bolt Ave
Tazewell, VA 24651-9703 - Phone
- (276) 988-2515
- NPI assigned
- Aug 6, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2202005778 | VA | Primary |
Addresses
Primary practice location
121 Ben Bolt Ave
Tazewell, VA 24651-9703
Mailing address
121 Ben Bolt Ave
Tazewell, VA 24651-9703
Phone (276) 988-2515
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2202005778 | VA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1281052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1281052800000",
"number": "1033423660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "121 BEN BOLT AVE",
"city": "TAZEWELL",
"state": "VA",
"postal_code": "246519703",
"telephone_number": "276-988-2515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 BEN BOLT AVE",
"city": "TAZEWELL",
"state": "VA",
"postal_code": "246519703",
"telephone_number": "276-988-2515"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITT",
"first_name": "KRISTOPHER",
"middle_name": "DEWAYNE",
"name_prefix": "Mr.",
"credential": "M.S. CCC-SLP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-08-06",
"last_updated": "2010-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202005778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tazewell, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.