Individual provider Active NPI

Jessica S Witmer, FNP

  • Primary Care Nurse Practitioner
  • Orrville, OH
National Provider Identifier
1962780429
Registry record updated Aug 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
12479 Issued in OH
Practice address
830 S Main St
Orrville, OH 44667-2291
Phone
(330) 684-2015
Fax
(330) 684-2075
NPI assigned
Aug 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 12479 OH Primary

Addresses

Primary practice location

830 S Main St
Orrville, OH 44667-2291

Mailing address

830 S Main St
Orrville, OH 44667-2291
Phone (330) 684-2015

Other identifiers 1

IdentifierTypeStateIssuer
12479-NPOtherOHCOA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120223000815 OH Practitioner - Nurse Practitioner 2860650793 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orrville Hospital FoundationGroup PAC ID 7911890546, 78 clinicians

Practice addresses (Care Compare)

830 S Main St
Orrville, OH 44667-2291
Phone (330) 684-2015

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
12479OHMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orrville Hospital Foundation CurrentSince Jun 1, 2016 Accepting new patients
Orrville Hospital Foundation CurrentSince Jun 1, 2016 Accepting new patients
Orrville Hospital Foundation Past Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

830 S Main St
Orrville, OH 44667
Phone (330) 684-2015

830 S Main St
Ste 511
Orrville, OH 44667
Phone (330) 684-2015

832 S Main St
Orrville, OH 44667
Phone (330) 456-2695

830 S Main St
Ste 59
Orrville, OH 44667

Interoperability endpoints

  • Direct secure messaging: jessica.witmer@direct.aultman.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312156800000",
    "number": "1962780429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 S MAIN ST",
            "city": "ORRVILLE",
            "state": "OH",
            "postal_code": "446672291",
            "telephone_number": "330-684-2015",
            "fax_number": "330-684-2075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 S MAIN ST",
            "city": "ORRVILLE",
            "state": "OH",
            "postal_code": "446672291",
            "telephone_number": "330-684-2015",
            "fax_number": "330-684-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITMER",
        "first_name": "JESSICA",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-01",
        "last_updated": "2011-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "12479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COA",
            "identifier": "12479-NP",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orrville, OH

Sources for this page

Verify at the official NPI Registry.