Active NPI
Michael C Witte, DO
- Pulmonary Disease Physician
- Des Moines, IA
National Provider Identifier
1619953627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- DO-02210
- Practice address
- 411 Laurel St Ste A120
Des Moines, IA 50314-3027 - Phone
- (515) 643-7900
- Fax
- (515) 643-7901
- NPI assigned
- Dec 21, 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 02210 | IA | |
| Pulmonary Disease Physician | 207RP1001X | DO-02210 | IA | Primary |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 02210 | IA |
Addresses
Primary practice location
411 Laurel St Ste A120
Des Moines, IA 50314-3027
Mailing address
PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-7900
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 18767 | Other | IA | MIDLAND'S CHOICE |
| IA0102 | Other | IA | UHC OF THE RIVER VALLEY |
| 25096 | Other | IA | WELLMARK |
| 0043034 | Medicaid | IA | |
| 73009 | Other | IA | COVENTRY |
| 852826 | Other | IA | UNITED HEALTHCARE |
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 Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 02210 | IA | MD | Pulmonary Disease Physician |
| DO-02210 | IA | MD | Pulmonary Disease Physician |
Interoperability endpoints
- michaelwitte@cicapc.allscriptsdirect.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605052800000",
"number": "1619953627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1475",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503051475",
"telephone_number": "515-643-7900",
"fax_number": "515-643-7901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "411 LAUREL ST STE A120",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503143027",
"telephone_number": "515-643-7900",
"fax_number": "515-643-7901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTE",
"first_name": "MICHAEL",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-21",
"last_updated": "2020-11-11",
"certification_date": "2020-11-11",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IA",
"license": "02210",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "IA",
"license": "DO-02210",
"primary": true
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "IA",
"license": "02210",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MIDLAND'S CHOICE",
"identifier": "18767",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC OF THE RIVER VALLEY",
"identifier": "IA0102",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK",
"identifier": "25096",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0043034",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY",
"identifier": "73009",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "852826",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.