Active NPI
David Charles Dewitt, MD
- Orthopaedic Surgery of the Spine Physician
- Appleton, WI
National Provider Identifier
1265424485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery of the Spine Physician
- License
- 43873-20
- Practice address
- 5320 W Michaels Drive
Appleton, WI 54913 - Phone
- (920) 882-8200
- Fax
- (920) 882-8210
- NPI assigned
- Aug 16, 2005
- Last updated
- Jul 22, 2022
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery of the Spine Physician | 207XS0117X | 43873-20 | WI | Primary |
| Surgery Physician | 208600000X | 43873-20 | WI |
Addresses
Primary practice location
5320 W Michaels Drive
Appleton, WI 54913
Mailing address
5320 W Michaels Drive
Appleton, WI 54913
Phone (920) 882-8200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34616400 | Medicaid | WI |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 43873-20 | WI | MD | Orthopaedic Surgery of the Spine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Spine Center of Wisconsin, LLC | Current | Accepting new patients |
Interoperability endpoints
- ddewitt92964@direct.myadvocateaurora.org
Organizations & group practices 1
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.
-
- Ambulatory Surgical Clinic/Center
- Neenah, WI
- NPI 1215492061
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658448000000",
"number": "1265424485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5320 W MICHAELS DRIVE",
"city": "APPLETON",
"state": "WI",
"postal_code": "54913",
"telephone_number": "920-882-8200",
"fax_number": "920-882-8210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5320 W MICHAELS DRIVE",
"city": "APPLETON",
"state": "WI",
"postal_code": "54913",
"telephone_number": "920-882-8200",
"fax_number": "920-882-8210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEWITT",
"first_name": "DAVID",
"middle_name": "CHARLES",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-16",
"last_updated": "2022-07-22",
"certification_date": "2022-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "207XS0117X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
"state": "WI",
"license": "43873-20",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "WI",
"license": "43873-20",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34616400",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Appleton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.