Active NPI
Marcus Michael Witter, P.T.
- Physical Therapist
- Sioux City, IA
National Provider Identifier
1972706794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 01862
- Practice address
- 4300 South Lakeport Road
Suite 101
Sioux City, IA 51106 - Phone
- (712) 266-0707
- Fax
- (712) 266-0709
- NPI assigned
- Jun 8, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 01862 | IA | Primary |
Addresses
Primary practice location
4300 South Lakeport Road
Suite 101
Sioux City, IA 51106
Mailing address
3325 N 129TH Cir
Omaha, NE 68164-4239
Phone (402) 616-3437
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 660 | NE | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back Care of Spirit Lake, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Medicine & Rehabilitation Physician
- Spirit Lake, IA
- NPI 1538122437
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972706794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3325 N 129TH CIR",
"city": "OMAHA",
"state": "NE",
"postal_code": "681644239",
"telephone_number": "402-616-3437",
"fax_number": "402-496-3595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4300 SOUTH LAKEPORT ROAD",
"address_2": "SUITE 101",
"city": "SIOUX CITY",
"state": "IA",
"postal_code": "51106",
"telephone_number": "712-266-0707",
"fax_number": "712-266-0709"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITTER",
"first_name": "MARCUS",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "01862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sioux City, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.