Wits Specialty Clinic PLLC

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

WITS SPECIALTY CLINIC PLLC

Practice address

9000 Tesoro Dr Ste 103
San Antonio, TX 78217-6100

Phone

(210) 322-0191

NPI assigned

Apr 3, 2024

Organization subpart

No

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

Authorized official

Name

Ms. Audrey Moody, NPNPI 1740990415

Title

Owner/ NP

Phone

(210) 322-0191

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Audrey Moody, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Converse, TX
  • NPI 1740990415

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1712102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712102400000",
    "number": "1528810439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9422 COPPERWAY",
            "city": "CONVERSE",
            "state": "TX",
            "postal_code": "781092063",
            "telephone_number": "210-322-0191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 TESORO DR STE 103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782176100",
            "telephone_number": "210-322-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WITS SPECIALTY CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-03",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "AUDREY",
        "authorized_official_title_or_position": "OWNER/ NP",
        "authorized_official_telephone_number": "210-322-0191",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Connor Wistrom, MD
• Katharine Johanna Wiswall, PA-C
• Kelly Wiswell
• Seth L Witcher, D.D.S.
• Lisa Witham, BSN, RN, CHPN
• Witt Psychotherapy, PLLC
• Debera Witt
• Justin M Witt, LCSW
• Nancy Sylvia L. Witt, PHD
• Amy Poore Witte, PHARM.D.

• Psychiatry Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.