Individual provider Active NPI

Kelly Lynn Wittenberg, RPH

  • Pharmacist
  • Hancock, MI
National Provider Identifier
1447188271
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302028511 Issued in MI
Practice address
500 Campus Dr
Hancock, MI 49930-1452
Phone
(906) 483-1919
Fax
(906) 483-1911
NPI assigned
May 12, 2026
Last updated
May 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302028511 MI Primary

Addresses

Primary practice location

500 Campus Dr
Hancock, MI 49930-1452

Mailing address

500 Campus Dr
Hancock, MI 49930-1452
Phone (906) 483-1919

Other practice location 1

600 MacInnes Dr
Houghton, MI 49931-1144
Phone (906) 483-1818

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302028511MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Town Pharmacy Inc Current 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1778544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1447188271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301452",
            "telephone_number": "906-483-1919",
            "fax_number": "906-483-1911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CAMPUS DR",
            "city": "HANCOCK",
            "state": "MI",
            "postal_code": "499301452",
            "telephone_number": "906-483-1919",
            "fax_number": "906-483-1911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 MacInnes Dr",
            "address_purpose": "LOCATION",
            "city": "Houghton",
            "state": "MI",
            "postal_code": "499311144",
            "country_code": "US",
            "telephone_number": "906-483-1818",
            "fax_number": "906-483-1811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITTENBERG",
        "first_name": "KELLY",
        "middle_name": "LYNN",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-12",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302028511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hancock, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.