Brenda S. Witsaman, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.022531 Issued in OH

Practice address

4800 Ledgewood Dr
Medina, OH 44256-7666

Phone

(330) 723-9688

NPI assigned

Mar 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ironwood Physicians, PC

  dba Ironwood Cancer & Research Centers, PC

  • Hematology & Oncology Physician
  • Chandler, AZ
  • NPI 1740269299
  Medicare reassignment NPD
• Ironwood Physicians, PC

  • Hematology & Oncology Physician
  • Goodyear, AZ
  • NPI 1598514408
  NPD
• Ironwood Physicians, PC

  • Hematology & Oncology Physician
  • Mesa, AZ
  • NPI 1851912158
  NPD

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1811492424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNIVERSITY OF AKRON, STUDENT HEALTH SERVICES",
            "address_2": "382 CARROLL ST., SUITE 260",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443250020",
            "telephone_number": "330-972-7808",
            "fax_number": "330-972-8849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 LEDGEWOOD DR",
            "city": "MEDINA",
            "state": "OH",
            "postal_code": "442567666",
            "telephone_number": "330-723-9688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITSAMAN",
        "first_name": "BRENDA",
        "middle_name": "S.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-26",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.022531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0290998",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Agnes Anna Wise
• Brenda Irvin Wise, MT-BC
• Jacquelyn N Wise
• Gina Wiseman, PTA
• Lisa M.T. Wiseman, OD
• Amy Witte, SLP
• Uwe Alfred Wolfram
• Bryce Wood
• Joellen Kae Woodring, LPCC-S
• Bridger James Woods

• Family Nurse Practitioner in Medina, OH
• Providers in Medina, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.

Verify at the official NPI Registry.