Bristol Auburn Witte, LMT, CCH

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MT21806580 Issued in IN

Practice address

3215 N Anthony Blvd Ste D
Fort Wayne, IN 46805-2259

Phone

(260) 704-2323

NPI assigned

Dec 29, 2019

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1577577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577577600000",
    "number": "1861031510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6457 FLUTTER RD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468359720",
            "telephone_number": "260-704-2323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3215 N ANTHONY BLVD STE D",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468052259",
            "telephone_number": "260-704-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTE",
        "first_name": "BRISTOL",
        "middle_name": "AUBURN",
        "credential": "LMT, CCH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-29",
        "last_updated": "2019-12-29",
        "certification_date": "2019-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "IN",
            "license": "MT21806580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "contact@trifectawellnessfw.com",
            "affiliation": "N",
            "endpointDescription": "Official Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Business Email via trifectawellnessfw.com domain",
            "address_1": "3215 N Anthony Blvd Ste D",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468052259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jamie Witherspoon
• Jessica Joy Witmer
• Ondreya Lee Witmer
• Ryan Witt, OT
• Brandon Witte, DPT
• Claire Elizabeth Witte, MA, CCC-SLP
• Ross Witte, PHARMD
• Tiffany R Witte, APRN
• Misty Woehler
• Eric Allen Woenker I

• Massage Therapist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Massage Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.