Active NPI
Richard L Witt, PA
- Medical Physician Assistant
- Tacoma, WA
National Provider Identifier
1417091182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA00746
- Practice address
- 9040 Jackson Avenue
Tacoma, WA 98431-5413 - Phone
- (253) 477-5053
- NPI assigned
- Feb 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA00746 | TX | Primary |
Addresses
Primary practice location
9040 Jackson Avenue
Tacoma, WA 98431-5413
Mailing address
5827 Southminster Dr
#55
Houston, TX 77035-5423
Phone (832) 338-3170
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
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA00746 | TX | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| C H Wilkinson Physician Network | Past | Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
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.
-
dba CHRISTUS Physician Group
- Family Medicine Physician
- Irving, TX
- NPI 1457382947
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641513600000",
"number": "1417091182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5827 SOUTHMINSTER DR",
"address_2": "#55",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770355423",
"telephone_number": "832-338-3170"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9040 JACKSON AVENUE",
"city": "TACOMA",
"state": "WA",
"postal_code": "984315413",
"telephone_number": "253-477-5053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITT",
"first_name": "RICHARD",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "PA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-16",
"last_updated": "2022-01-07",
"certification_date": "2022-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA00746",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 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.