Individual provider Active NPI

Emily Marie Witt, SA-C

  • Surgery Physician
  • Parker, CO
National Provider Identifier
1891202479
Registry record updated Jan 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
17-182 Issued in CO
Practice address
11960 Lioness Way Ste 120
Parker, CO 80134-5640
Phone
(720) 542-6700
NPI assigned
Jan 4, 2018
Last updated
Jan 4, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 17-182 CO Primary

Addresses

Primary practice location

11960 Lioness Way Ste 120
Parker, CO 80134-5640

Mailing address

PO Box 1460
Frisco, CO 80443-1460
Phone (419) 356-0331

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

State licenses

LicenseStateTypeSpecialty
17-182COMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1515024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515024000000",
    "number": "1891202479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "city": "FRISCO",
            "state": "CO",
            "postal_code": "804431460",
            "telephone_number": "419-356-0331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11960 LIONESS WAY STE 120",
            "city": "PARKER",
            "state": "CO",
            "postal_code": "801345640",
            "telephone_number": "720-542-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITT",
        "first_name": "EMILY",
        "middle_name": "MARIE",
        "credential": "SA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-01-04",
        "last_updated": "2018-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "17-182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parker, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2018; 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.