Kristin R. Witzenburg, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1410 SW Tradition Dr Ste 110
Ankeny, IA 50023-9188

Phone

(515) 875-9696

Fax

(515) 875-9697

NPI assigned

Feb 7, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Kristin R Chung Former name

Medicare fee-for-service enrollment

Enrolled in IA

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.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Iowa Clinic PCGroup PAC ID 4082513742, 307 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristin.witzenburg.1@25062.direct.athenahealth.com

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.

• The Iowa Clinic PC

  dba The Iowa Clinic

  • Family Medicine Physician
  • West Des Moines, IA
  • NPI 1346233178
  Medicare reassignment Care Compare group NPD
• The Iowa Clinic, PC

  • Durable Medical Equipment & Medical Supplies
  • West Des Moines, IA
  • NPI 1871451328
  NPD
• QV Urgent Care Ia PLLC

  dba QuickVisit Urgent Care

  • Urgent Care Clinic/Center
  • Mt Pleasant, IA
  • NPI 1407465917
  NPD (past)

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

{
    "created_epoch": "1391731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1306260682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 RANDALL PL",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503112716",
            "telephone_number": "515-250-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1410 SW TRADITION DR STE 110",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500239188",
            "telephone_number": "515-875-9696",
            "fax_number": "515-875-9697"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2720 8th St SW",
            "address_purpose": "LOCATION",
            "city": "Altoona",
            "state": "IA",
            "postal_code": "500091028",
            "country_code": "US",
            "telephone_number": "515-957-3661",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITZENBURG",
        "first_name": "KRISTIN",
        "middle_name": "R.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-07",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "073924",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTIN",
            "last_name": "CHUNG",
            "middle_name": "R",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Terris Elmer Williams Jr., DDS
• Chloe Williamson
• Mark Wills, LMSW
• Kelsey Winnett, DC
• Austin Thomas Wiser, PHARMD
• Kelly Ann Wolf, BSPH
• Lola Wolf
• Womens Counseling Center Inc
• Julia Woods, MS
• Nicholas Woolley

• Physician Assistant in Ankeny, IA
• Providers in Ankeny, IA by specialty
• Physician Assistant in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.