NPIMap

Individual provider Active NPI

Brian P Witwer, MD

  • Neurological Surgery Physician
  • Grand Junction, CO
National Provider Identifier
1982698148
Registry record updated Sep 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
41914 Issued in CO
Practice address
750 Wellington Ave Ste 3a
Grand Junction, CO 81501-6132
Phone
(970) 298-3188
Fax
(970) 298-3190
NPI assigned
Sep 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 41914 CO Primary

Addresses

Primary practice location

750 Wellington Ave Ste 3a
Grand Junction, CO 81501-6132

Mailing address

PO Box 62
Grand Junction, CO 81502-0062
Phone (970) 298-2273

Other practice location 1

401 Kokopelli Blvd Ste 1
Fruita, CO 81521-3308
Phone (970) 858-2580

Other practice location 2

300 W Ottley Ave
Fruita, CO 81521-2118
Phone (970) 858-2186

Other identifiers 1

IdentifierTypeStateIssuer
37407074MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040422000057 CO Practitioner - Neurosurgery 6901892348 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Temple University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

2635 N 7TH St
Grand Junction, CO 81501-8209

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion102
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Laminectomy or laminotomy (partial removal of spine bones)15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41914COMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC Neurological Surgery CurrentSince May 20, 2014 Accepting new patients
St Mary'S Hospital and Medical Center, Inc CurrentSince Oct 6, 2006 Accepting new patients
St Mary'S Hospital and Medical Center, Inc Neurological Surgery Current Accepting new patients
St Mary'S Hospital and Medical Center, Inc CurrentSince Oct 6, 2006 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince May 20, 2014 Accepting new patients
St. Mary'S Hospital and Medical Center, Inc. Past Accepting new patients
Neurosurgical Consultants LLP Past Accepting new patients
Larry D. Tice MD PC Neurological Surgery Past Accepting new patients
Neurosurgical Consultants LLP Neurological Surgery PastSince Apr 26, 2003 Accepting new patients

Locations

750 Wellington Ave
Ste 3A
Grand Junction, CO 81501
Phone (970) 248-3188

2635 N 7th St
Grand Junction, CO 81501
Phone (970) 244-2009

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

Interoperability endpoints

  • Direct secure messaging: bwitwer15550@direct.intermountainhealth.org

Organizations & group practices 9

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 7

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": "1125619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537142400000",
    "number": "1982698148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815020062",
            "telephone_number": "970-298-2273",
            "fax_number": "970-298-1809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 WELLINGTON AVE STE 3A",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815016132",
            "telephone_number": "970-298-3188",
            "fax_number": "970-298-3190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Kokopelli Blvd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Fruita",
            "state": "CO",
            "postal_code": "815213308",
            "country_code": "US",
            "telephone_number": "970-858-2580",
            "fax_number": "970-858-3211",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 W Ottley Ave",
            "address_purpose": "LOCATION",
            "city": "Fruita",
            "state": "CO",
            "postal_code": "815212118",
            "country_code": "US",
            "telephone_number": "970-858-2186",
            "fax_number": "970-858-2208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WITWER",
        "first_name": "BRIAN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-02",
        "last_updated": "2018-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "CO",
            "license": "41914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "37407074",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.