Active NPI
Susan M Wittman, RPH
- Community Health Clinic/Center
- Hartford, WI
National Provider Identifier
1942649009
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community Health Clinic/Center
- License
- 8686-40
- Practice address
- 1275 Bell Ave
Hartford, WI 53027-1976 - Phone
- (262) 673-7339
- NPI assigned
- Jun 21, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Community Health Clinic/Center | 261QC1500X | 8686-40 | WI | Primary |
Addresses
Primary practice location
1275 Bell Ave
Hartford, WI 53027-1976
Mailing address
1583 Bluebell Dr
Hartford, WI 53027-8403
Phone (262) 397-8481
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8686-40 | WI | MD | Community Health Clinic/Center |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371772800000",
"number": "1942649009",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1583 BLUEBELL DR",
"city": "HARTFORD",
"state": "WI",
"postal_code": "530278403",
"telephone_number": "262-397-8481"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 BELL AVE",
"city": "HARTFORD",
"state": "WI",
"postal_code": "530271976",
"telephone_number": "262-673-7339"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTMAN",
"first_name": "SUSAN",
"middle_name": "M",
"name_prefix": "Ms.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-06-21",
"last_updated": "2013-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "261QC1500X",
"taxonomy_group": "",
"desc": "Clinic/Center, Community Health",
"state": "WI",
"license": "8686-40",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hartford, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.