Active NPI
Keith A Witt, R.PH.
- Pharmacist
- East Troy, WI
National Provider Identifier
1063493047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11834-040
- Practice address
- 3284 Main St
East Troy, WI 53120-1152 - Phone
- (262) 642-3510
- Fax
- (262) 642-3512
- NPI assigned
- Nov 8, 2005
- Last updated
- Mar 19, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 051-033918 | IL | |
| Pharmacist | 183500000X | 11834-040 | WI | Primary |
Addresses
Primary practice location
3284 Main St
East Troy, WI 53120-1152
Mailing address
3284 Main St
P.O. Box 255
East Troy, WI 53120-1152
Phone (262) 642-3510
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 051-033918 | IL | MD | Pharmacist |
| 11834-040 | WI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| BCS Health LLC | Current | Accepting new patients | |
| BCS Health LLC | Current | Accepting new patients |
Locations
3284 Main St
East Troy, WI 53120
Phone (262) 642-3510
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363651200000",
"number": "1063493047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3284 MAIN ST",
"address_2": "P.O. BOX 255",
"city": "EAST TROY",
"state": "WI",
"postal_code": "531201152",
"telephone_number": "262-642-3510",
"fax_number": "262-642-3512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3284 MAIN ST",
"city": "EAST TROY",
"state": "WI",
"postal_code": "531201152",
"telephone_number": "262-642-3510",
"fax_number": "262-642-3512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITT",
"first_name": "KEITH",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "R.PH.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-08",
"last_updated": "2013-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IL",
"license": "051-033918",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WI",
"license": "11834-040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in East Troy, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.