Active NPI
Marybeth Witcher, F.N.P.
- Family Nurse Practitioner
- Valparaiso, IN
National Provider Identifier
1629120878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71000341A
- Practice address
- 1001 Sturdy Rd
Valparaiso, IN 46383-4126 - Phone
- (219) 462-7173
- Fax
- (219) 462-7504
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71000341A | IN | Primary |
Addresses
Primary practice location
1001 Sturdy Rd
Valparaiso, IN 46383-4126
Mailing address
951 Transport Dr
Valparaiso, IN 46383-8434
Phone (219) 477-6082
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200321550A | Medicaid | IN |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71000341A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthlinc, Inc. | Current | Accepting new patients | |
| Healthlinc, Inc | Current | Accepting new patients |
Locations
1001 Sturdy Rd
Valparaiso, IN 46383
Phone (219) 462-7173
951 Transport Dr
Valparaiso, IN 46383
Phone (219) 464-4100
2401 Valley Dr
Valparaiso, IN 46383
Phone (219) 413-5100
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 and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Valparaiso, IN
- NPI 1528262581
-
- Federally Qualified Health Center (FQHC)
- Morocco, IN
- NPI 1568354116
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466380800000",
"number": "1629120878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "951 TRANSPORT DR",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463838434",
"telephone_number": "219-477-6082",
"fax_number": "219-465-9502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 STURDY RD",
"city": "VALPARAISO",
"state": "IN",
"postal_code": "463834126",
"telephone_number": "219-462-7173",
"fax_number": "219-462-7504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITCHER",
"first_name": "MARYBETH",
"credential": "F.N.P.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2016-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71000341A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200321550A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Valparaiso, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.