MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.) – Family Nurse Practitioner, NPI 1124026018

MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.) is a healthcare provider. based in Saginaw, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials N.P.. They hold a License No. 4704189159 (MI). The NPI Number for MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.) is 1124026018

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.)
NPI
1124026018
Phone
(989) 792-4090
Address
4450 FASHION SQUARE BLVD
Enumeration Date
13 July 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
UNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Secondary Phone
9897924090
Graduation Year
2002 (24 years ago)
PAC ID
3678623360
Group Practice PAC ID
6507099207
Professional Enrollment ID
I20090618000618
Address ID
MI486031251SA4450XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

8,105 NURSE PRACTITIONER in MI

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Provider Addresses for MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.)

  • 4450, Fashion Square Boulevard, Saginaw Charter Township, Saginaw County, Michigan, 48603, United States

    SAGINAW, MI 486031251

    Phone: (989) 792-4090

    Fax: (989) 792-4094

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 9 Open Payments records for all available years, with a total value of $192.

Total Amount is formed as General ($192) + Research ($0) + Ownership ($0) = $192.

Last reported payment date: 2024-03-14 • Largest payer in this snapshot: Nevro Corp. ($53).

Total Amount

$192

General + Research + Ownership

Payments

9

Total payment records

General Amount

$192

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-03-14

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2009-06-18

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090618000618INurse PractitionerMITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes561191$0
G0482Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms142105$0
80307Testing for presence of drug, by chemistry analyzers12098$0
G0481Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms9477$0
62370Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician6516$0
View full utilization report →

Insurance plans in this area (ZIP 48603)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6507099207View full group profile
NameSpecialtyState
-IL
Physical Medicine And RehabilitationMI
Nurse PractitionerMI
Physical Medicine And RehabilitationMI
Physical Medicine And RehabilitationMI
Anesthesiology, Pain ManagementMI
Nurse PractitionerMI
Anesthesiology, Pain ManagementAL
Nurse PractitionerMI

Reviews

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Frequently asked questions

What is the 10-digit NPI for MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.)?
MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.) — NPI 1124026018 — is the standard way to identify this listing.
Does the file indicate MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.) is practicing under active NPI?
Directory data currently reports MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.) as active.
What is MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.) best known for clinically?
Directory data describes MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where should I expect MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.) on a map?
Expect Saginaw, Michigan as a primary anchor for MRS. CAROLYN DIANNE LEADHOLM-WITTKE (N.P.) unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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