Individual provider Active NPI

Amber Wittkorn, CFNP, MSN, BS, RN

  • Family Medicine Physician
  • Cincinnati, OH
National Provider Identifier
1881253318
Registry record updated Jun 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
APRN.CNP.024696 Issued in OH
Practice address
3012 Glenmore Ave Ste 104
Cincinnati, OH 45238-2258
Phone
(385) 202-6167
NPI assigned
Jun 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X APRN.CNP.024696 OH Primary

Addresses

Primary practice location

3012 Glenmore Ave Ste 104
Cincinnati, OH 45238-2258

Mailing address

2622 Moorman Ave Apt 3
Cincinnati, OH 45206-2126

Other identifiers 1

IdentifierTypeStateIssuer
4009MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Cincinnati Health Information Exchange (HIE)

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)
Not enrolled
Credentials
Bachelor of Science, Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
APRN.CNP.024696OHMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1560038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560038400000",
    "number": "1881253318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2622 MOORMAN AVE APT 3",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452062126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3012 GLENMORE AVE STE 104",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452382258",
            "telephone_number": "385-202-6167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITTKORN",
        "first_name": "AMBER",
        "credential": "CFNP, MSN, BS, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-09",
        "last_updated": "2019-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "APRN.CNP.024696",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4009",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Cincinnati",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3012 Glenmore Ave Ste 104",
            "city": "Cincinnati",
            "state": "OH",
            "country_code": "US",
            "postal_code": "452382258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.