Active NPI
Melissa Jane Wittenburg, M.S.O.T.
- Occupational Therapist
- Waverly, IA
National Provider Identifier
1831377902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 01797
- Practice address
- 312 9TH St SW
Waverly, IA 50677-2929 - Phone
- (319) 352-5644
- NPI assigned
- Jan 31, 2008
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 01797 | IA | Primary |
Addresses
Primary practice location
312 9TH St SW
Waverly, IA 50677-2929
Mailing address
312 9TH St SW
Waverly, IA 50677-2929
Phone (319) 352-5644
Other names 1
- Melissa Jane Davis
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01797 | IA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201737600000",
"number": "1831377902",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "312 9TH ST SW",
"city": "WAVERLY",
"state": "IA",
"postal_code": "506772929",
"telephone_number": "319-352-5644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "312 9TH ST SW",
"city": "WAVERLY",
"state": "IA",
"postal_code": "506772929",
"telephone_number": "319-352-5644"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTENBURG",
"first_name": "MELISSA",
"middle_name": "JANE",
"credential": "M.S.O.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-31",
"last_updated": "2008-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "IA",
"license": "01797",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "DAVIS",
"middle_name": "JANE",
"credential": "M.S.O.T.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Waverly, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.