Individual provider Active NPI

Lauren Hillam Wittwer, DNP, CPNP-PC, RN

  • Pediatric Nurse Practitioner
  • Holly Springs, NC
National Provider Identifier
1356072128
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
5016406 Issued in NC
Practice address
500 Holly Springs Rd Ste 101
Holly Springs, NC 27540-6204
Phone
(919) 701-8057
NPI assigned
Jun 22, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 5016406 NC Primary

Addresses

Primary practice location

500 Holly Springs Rd Ste 101
Holly Springs, NC 27540-6204

Mailing address

203 Glenshire CT
Apex, NC 27502-9640
Phone (801) 361-0301

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)
Not enrolled
Credentials
Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
5016406NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cary Pediatric Center PA Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1356072128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 GLENSHIRE CT",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275029640",
            "telephone_number": "801-361-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 HOLLY SPRINGS RD STE 101",
            "city": "HOLLY SPRINGS",
            "state": "NC",
            "postal_code": "275406204",
            "telephone_number": "919-701-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTWER",
        "first_name": "LAUREN",
        "middle_name": "HILLAM",
        "credential": "DNP, CPNP-PC, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5016406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holly Springs, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.

Verify at the official NPI Registry.