Andrea Shea Witham, FNP-C, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

202201834NP Issued in OR

Practice address

753 SE Main St Ste 205
Roseburg, OR 97470-3985

Phone

(503) 455-7656

Fax

(503) 457-0645

NPI assigned

Jun 9, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2026 through Apr 1, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Floss Mental Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Roseburg, OR
  • NPI 1972211324
  NPD Authorized official

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1275982324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 SE MAIN ST STE 205",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703985",
            "telephone_number": "503-455-7656",
            "fax_number": "503-457-0645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 SE MAIN ST STE 205",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703985",
            "telephone_number": "503-455-7656",
            "fax_number": "503-457-0645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHAM",
        "first_name": "ANDREA",
        "middle_name": "SHEA",
        "credential": "FNP-C, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202201834NP-PP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "202201834NP",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP9762",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice I Winstead, CADCII
• Stephanie Wirth
• Derek Wiseman, MD
• Michelle Wissel, CADC
• Linda Witbeck
• Chelsea Lynn Wold, LCSW
• Lesa Wolfe
• Azure Noelle Wolford
• Charie Renea Wolford, RN
• Keith R. Wolford, OTR/L

• Psychiatric/Mental Health Nurse Practitioner in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.