Active NPI
Stephanie Witt, PHARM. D.
- Pharmacist
- Logan, IA
National Provider Identifier
1073908448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 21266
- Practice address
- 103 N 4TH Ave
Logan, IA 51546-1335 - Phone
- (712) 644-2160
- NPI assigned
- Apr 2, 2015
- Last updated
- Apr 2, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 21266 | IA | Primary |
Addresses
Primary practice location
103 N 4TH Ave
Logan, IA 51546-1335
Mailing address
103 N 4TH Ave
Logan, IA 51546-1335
Phone (712) 644-2160
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21266 | IA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Witt Family Pharmacy Inc. | Current | Accepting new patients | |
| Eby Drug Store (Logan), Inc | Past | Accepting new patients |
Locations
103 N 4th Ave
Logan, IA 51546
Phone (712) 644-2160
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.
-
- Community/Retail Pharmacy
- Logan, IA
- NPI 1821189366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427932800000",
"number": "1073908448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "103 N 4TH AVE",
"city": "LOGAN",
"state": "IA",
"postal_code": "515461335",
"telephone_number": "712-644-2160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 N 4TH AVE",
"city": "LOGAN",
"state": "IA",
"postal_code": "515461335",
"telephone_number": "712-644-2160"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITT",
"first_name": "STEPHANIE",
"credential": "PHARM. D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-02",
"last_updated": "2015-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "21266",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.