Active NPI
Frederick R Witten, MD
- Urology Physician
- Jeffersonville, IN
National Provider Identifier
1588657654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 23489
- Practice address
- 101 Hospital Blvd
Jeffersonville, IN 47130-3769 - Phone
- (812) 282-3899
- Fax
- (812) 282-4172
- NPI assigned
- Aug 24, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 01040421A | IN | |
| Urology Physician | 208800000X | 23489 | KY | Primary |
Addresses
Primary practice location
101 Hospital Blvd
Jeffersonville, IN 47130-3769
Mailing address
101 Hospital Blvd
Jeffersonville, IN 47130-3769
Phone (812) 282-3899
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64234891 | Medicaid | KY | |
| 201011460 | Medicaid | IN | |
| P00304320 | Other | KY | RAILROAD MEDICARE |
| P00895255 | Other | KY | RAILROAD MEDICARE |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01040421A | IN | MD | Urology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1506297600000",
"number": "1588657654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 HOSPITAL BLVD",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471303769",
"telephone_number": "812-282-3899",
"fax_number": "812-282-4172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 HOSPITAL BLVD",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471303769",
"telephone_number": "812-282-3899",
"fax_number": "812-282-4172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTEN",
"first_name": "FREDERICK",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-24",
"last_updated": "2017-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IN",
"license": "01040421A",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "KY",
"license": "23489",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64234891",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "201011460",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00304320",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00895255",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Jeffersonville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.