Individual provider Active NPI

Kristi Witcher, MD

  • Emergency Medicine Physician
  • Papillion, NE
National Provider Identifier
1417046079
Registry record updated Apr 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
21339 Issued in NE
Practice address
11111 S 84TH St
Papillion, NE 68046-4122
Phone
(402) 593-3550
NPI assigned
Oct 12, 2006
Last updated
Apr 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 21339 NE Primary

Addresses

Primary practice location

11111 S 84TH St
Papillion, NE 68046-4122

Mailing address

4750 Hempstead Station Dr
Kettering, OH 45429-5164
Phone (800) 875-0136

Other identifiers 5

IdentifierTypeStateIssuer
100249951-00MedicaidNE
32271OtherNEBCBS
253086OtherNEMLDCH & MUTUAL OF OMAHA
0764712MedicaidIA
39-02336OtherSHARE ADVANTAGE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121210000270 AL Practitioner - Emergency Medicine 3577667039 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Arizona College of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Physicians GroupGroup PAC ID 5496669350, 47 clinicians
Emergency Services of Montgomery PCGroup PAC ID 6608028204, 61 clinicians

Practice addresses (Care Compare)

101 Sivley Rd SW
Huntsville, AL 35801-4421
Phone (256) 265-9889

124 S Memorial Dr
Prattville, AL 36067-3619
Phone (334) 365-0651

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Paragon Contracting Services LLC Emergency Medicine CurrentSince Jun 14, 2021 Accepting new patients
Emergency Services of Montgomery PC Emergency Medicine CurrentSince Nov 1, 2012 Accepting new patients
Emergency Physicians Group Emergency Medicine CurrentSince Aug 1, 2022 Accepting new patients
Louisiana Em-1 Medical Services, PC Past Accepting new patients
Texas Trail Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

810 Saint Vincents Dr
Birmingham, AL 35205
Phone (205) 930-2456

101 Sivley Rd SW
Huntsville, AL 35801
Phone (256) 265-9870

8375 Highway 72 W
Madison, AL 35758
Phone (256) 265-2012

2105 E South Blvd
Montgomery, AL 36116
Phone (334) 286-2842

124 S Memorial Dr
Prattville, AL 36067
Phone (334) 361-4267

Interoperability endpoints

  • Direct secure messaging: kristi.witcher@direct.baptistfirst.org

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 1

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238544000000",
    "number": "1417046079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 S 84TH ST",
            "city": "PAPILLION",
            "state": "NE",
            "postal_code": "680464122",
            "telephone_number": "402-593-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITCHER",
        "first_name": "KRISTI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2009-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NE",
            "license": "21339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100249951-00",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "32271",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MLDCH & MUTUAL OF OMAHA",
            "identifier": "253086",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0764712",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SHARE ADVANTAGE",
            "identifier": "39-02336",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Papillion, NE

Sources for this page

Verify at the official NPI Registry.