Individual provider Active NPI

Elizabeth Gaddy Witman, M.D.

  • Pediatrics Physician
  • Raleigh, NC
National Provider Identifier
1831117688
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
32914 Issued in NC
Practice address
3024 New Bern Ave
Suite 307 - Pediatrics
Raleigh, NC 27610-1247
Phone
(919) 350-8493
Fax
(919) 350-8677
NPI assigned
Jul 18, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 32914 NC Primary

Addresses

Primary practice location

3024 New Bern Ave
Suite 307 - Pediatrics
Raleigh, NC 27610-1247

Mailing address

3024 New Bern Ave
Suite 300
Raleigh, NC 27610-1247
Phone (919) 350-8228

Other identifiers 1

IdentifierTypeStateIssuer
7988703MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140616001507 NC Practitioner - Pediatric Medicine 6507080488 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
32914NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Jan 23, 2021 Accepting new patients
Wakemed Specialists Group LLC Pediatrics CurrentSince Jan 23, 2021 Accepting new patients
Wake Specialty Physicians LLC Pediatrics CurrentSince Apr 21, 2014 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Wake Specialty Physicians, LLC Pediatrics CurrentSince Apr 21, 2014 Accepting new patients
Wakemed Faculty Practice Plan Past Accepting new patients
Wakemed Faculty Practice Plan Pediatrics Past Accepting new patients

Locations

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

2820 Kidd Rd
Raleigh, NC 27610
Phone (919) 231-8315

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

3024 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-5318

3024 New Bern Ave
Ste 300
Raleigh, NC 27610
Phone (919) 350-8228

3024 New Bern Ave
Ste 307
Raleigh, NC 27610
Phone (919) 350-7231

Interoperability endpoints

  • Direct secure messaging: ewitman11735@directhisp.wakemed.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831117688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 NEW BERN AVE",
            "address_2": "SUITE 300",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101247",
            "telephone_number": "919-350-8228",
            "fax_number": "919-350-7976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3024 NEW BERN AVE",
            "address_2": "SUITE 307 - PEDIATRICS",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101247",
            "telephone_number": "919-350-8493",
            "fax_number": "919-350-8677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITMAN",
        "first_name": "ELIZABETH",
        "middle_name": "GADDY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "32914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7988703",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.