MALLORY RENEE WITTIG (FNP) – Family Nurse Practitioner, NPI 1114285517
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for MALLORY RENEE WITTIG (FNP)
12 HOSPITAL DR
METROPOLIS, IL 629602461
Phone: (618) 524-2182
Fax: (618) 524-2451
Type: Mailing
28 Chick St
Metropolis, IL 629602467
Phone: (618) 524-2176
Fax: (618) 524-4131
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 190 Open Payments records for all available years, with a total value of $3,169.
Total Amount is formed as General ($3,169) + Research ($0) + Ownership ($0) = $3,169.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: AstraZeneca Pharmaceuticals LP ($663).
Total Amount
$3,169
General + Research + Ownership
Payments
190
Total payment records
General Amount
$3,169
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| AstraZeneca Pharmaceuticals LP | $663 |
| Novo Nordisk Inc | $647 |
| GlaxoSmithKline, LLC. | $480 |
| Bayer Healthcare Pharmaceuticals Inc. | $289 |
| ABBVIE INC. | $190 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2012-10-29
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20121029000755 | I | Nurse Practitioner | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62960)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Mental Health Counselor | IL | |
| Family Practice, Emergency Medicine | IL | |
| Physician Assistant | TN | |
| O T O L A R Y N G O L O G Y | KY | |
| Family Practice | IL | |
| Family Practice | GA | |
| P S Y C H I A T R Y | IN |
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