Individual provider Active NPI

Tiffany R Witte, APRN

  • Family Nurse Practitioner
  • Fort Wayne, IN
National Provider Identifier
1598435521
Registry record updated Sep 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71011504A Issued in IN
Practice address
6017 Stoney Creek Dr
Fort Wayne, IN 46825-4410
Phone
(260) 267-5159
NPI assigned
Sep 21, 2021
Last updated
Sep 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71011504A IN Primary

Addresses

Primary practice location

6017 Stoney Creek Dr
Fort Wayne, IN 46825-4410

Mailing address

215 Stratton Way
Decatur, IN 46733-1717
Phone (260) 701-8433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220125000962 IN Practitioner - Nurse Practitioner 5698167658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Associates PCGroup PAC ID 3375504301, 36 clinicians

Practice addresses (Care Compare)

10021 Dupont Circle CT
Fort Wayne, IN 46825-1604
Phone (260) 426-8117

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71011504AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ear, Nose & Throat Associates, PC CurrentSince Jan 19, 2022 Accepting new patients
The Hearing Center LLC Past Accepting new patients

Locations

424 Williams St
Angola, IN 46703
Phone (260) 665-2926

1169 N Main St
Ste 5
Bluffton, IN 46714
Phone (260) 827-4368

10021 DuPont Circle Ct
Fort Wayne, IN 46825
Phone (219) 426-8117

5411 Meijer Dr
Fort Wayne, IN 46835
Phone (260) 469-6919

7926 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 459-6924

2003 Stults Rd
Ste 220
Huntington, IN 46750
Phone (260) 463-2133

2814 Theater Ave
Huntington, IN 46750
Phone (260) 356-3611

1655 N Cass St
Wabash, IN 46992
Phone (260) 463-2133

442 W High St
Bryan, OH 43506
Phone (260) 266-8210

140 Fox Rd
Van Wert, OH 45891
Phone (419) 238-7700

Organizations & group practices 2

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 5

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": "1632182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1598435521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 STRATTON WAY",
            "city": "DECATUR",
            "state": "IN",
            "postal_code": "467331717",
            "telephone_number": "260-701-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6017 STONEY CREEK DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468254410",
            "telephone_number": "260-267-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTE",
        "first_name": "TIFFANY",
        "middle_name": "R",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-21",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71011504A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.