Kathleen R Wittberg, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35048051 Issued in OH

Practice address

9000 North Main St
Main Street Family Practice Inc Suite 403
Dayton, OH 45415-1180

Phone

(937) 836-5171

Fax

(937) 832-0728

NPI assigned

Jul 26, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Five Rivers Health Centers

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1669143061
  Medicare reassignment
• Five Rivers Health Centers

  • Family Medicine Physician
  • Dayton, OH
  • NPI 1053600775
  NPD
• Five Rivers Health Centers

  • Family Medicine Physician
  • Xenia, OH
  • NPI 1083501415
  NPD
• Five Rivers Health Centers

  • Internal Medicine Physician
  • Dayton, OH
  • NPI 1356721286
  NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206316800000",
    "number": "1144220641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 NORTH MAIN ST",
            "address_2": "SUITE 403 MAIN STREET FAMILY PRACTICE INC",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-836-1572",
            "fax_number": "937-832-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 NORTH MAIN ST",
            "address_2": "MAIN STREET FAMILY PRACTICE INC SUITE 403",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-836-5171",
            "fax_number": "937-832-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTBERG",
        "first_name": "KATHLEEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2008-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35048051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1139935",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM  DR WITTBERG",
            "identifier": "000000013668",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA  DR WITTBERG",
            "identifier": "4328348",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0534265",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC DR WITTBERG",
            "identifier": "0122424",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marion Witcher
• Freshana S Withrow-Harris, LSW
• Ashley E Withrow
• Jeremy Lee Withrow
• Sara Witt, RN
• Richard Witte, MD
• Brian P Wlodarczyk, LISW
• Paige Sophia Wnek
• Julia M Woelfel
• Zach T Woessner, PSY.D.

• Family Medicine Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.