NPIMap

Individual provider Active NPI

Michele Nicole Mulligan-Witt, MD

  • Family Medicine Physician
  • Valentine, NE
National Provider Identifier
1184734592
Registry record updated Jan 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
21205 Issued in NE
Practice address
502 N Cherry St
Valentine, NE 69201-1518
Phone
(402) 376-2200
Fax
(402) 376-2219
NPI assigned
Aug 30, 2006
Last updated
Jan 21, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 21205 NE Primary

Addresses

Primary practice location

502 N Cherry St
Valentine, NE 69201-1518

Mailing address

502 N Cherry St
Valentine, NE 69201-1518
Phone (402) 376-2200

Other identifiers 1

IdentifierTypeStateIssuer
47083768827MedicaidNE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100329000292 NE Practitioner - Family Practice 9335228717 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Nebraska College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherry County HospitalGroup PAC ID 5698686012, shared by 6 NPIs, 24 clinicians

Practice addresses (Care Compare)

510 N Green St
Valentine, NE 69201-1932
Phone (402) 376-2525

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Cherry County Hospital Family Medicine CurrentSince Feb 1, 2020 Accepting new patients
Cherry County Hospital Current Accepting new patients
Valentine Medical Clinic, LLC Family Medicine CurrentSince Jan 1, 1990 Accepting new patients
Cherry County Hospital CurrentSince Feb 1, 2020 Accepting new patients

Locations

502 N Cherry St
Valentine, NE 69201
Phone (402) 376-2200

510 N Green St
Valentine, NE 69201
Phone (402) 376-3770

512 N Green St
Valentine, NE 69201
Phone (402) 376-3770

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Cherry County HospitalValentine, NE, CCN 281344 Hospital W-2 Managing Employee
Operational/Managerial Control		 May 2, 2022
Apr 1, 2011
Cherry County HospitalValentine, NE, CCN 28Z344 Hospital W-2 Managing Employee
Operational/Managerial Control		 May 2, 2022
Apr 1, 2011
Cherry Co Hospital Home Health ServicesValentine, NE, CCN 287059 Home health agency Contracted Managing Employee
Operational/Managerial Control		 Apr 1, 2011
Apr 1, 2011

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264032000000",
    "number": "1184734592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 N CHERRY ST",
            "city": "VALENTINE",
            "state": "NE",
            "postal_code": "692011518",
            "telephone_number": "402-376-2200",
            "fax_number": "402-376-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 N CHERRY ST",
            "city": "VALENTINE",
            "state": "NE",
            "postal_code": "692011518",
            "telephone_number": "402-376-2200",
            "fax_number": "402-376-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLIGAN-WITT",
        "first_name": "MICHELE",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2010-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NE",
            "license": "21205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47083768827",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Valentine, NE

Sources for this page

Verify at the official NPI Registry.