KELLY LORRAINE WITTE (PA-C) – Physician Assistant, NPI 1073905741

KELLY LORRAINE WITTE (PA-C) is a healthcare provider. based in Colville, Washington. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 60697687 (WA). The NPI Number for KELLY LORRAINE WITTE (PA-C) is 1073905741

Main info

Female
10 Years Of Experience
Accepts Medicare Assignment
Name
KELLY LORRAINE WITTE (PA-C)
NPI
1073905741
Phone
(509) 684-1440
Address
358 N MAIN ST
Enumeration Date
4 March 2015
Last Update Date
1 January 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5097324252
Graduation Year
2016 (10 years ago)
PAC ID
1153609334
Group Practice PAC ID
1951202373
Professional Enrollment ID
I20161021001148
Address ID
WA991570178NO411XXSUMM200
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness75
Years active:11State licenses:1Digital endpointsOther names

4,282 PHYSICIAN ASSISTANT in WA

Provider Addresses for KELLY LORRAINE WITTE (PA-C)

  • 358 N MAIN ST

    COLVILLE COMMUNITY HEALTH CLINIC

    COLVILLE, WA 991142310

    Phone: (509) 684-1440

    Fax: (509) 684-2745

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2016-10-21

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
I20161021001148IPhysician AssistantWATBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99114)

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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: 1951202373View full group profile
NameSpecialtyState
Nurse PractitionerWA
Nurse PractitionerCA
Nurse PractitionerFL
-WA
Nurse PractitionerWA
Internal MedicineWA
Family PracticeWA
-WA
Nurse PractitionerWA
Physician AssistantMT

Reviews

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Frequently asked questions

Does KELLY LORRAINE WITTE (PA-C) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KELLY LORRAINE WITTE (PA-C) uses 1073905741.
Can I rely on KELLY LORRAINE WITTE (PA-C) being an active provider?
As of the registry snapshot, KELLY LORRAINE WITTE (PA-C) is marked active.
What taxonomy line describes KELLY LORRAINE WITTE (PA-C)?
For research purposes, treat KELLY LORRAINE WITTE (PA-C) as Physician Assistant in this dataset. Clinical services aligned with this taxonomy classification.
Does KELLY LORRAINE WITTE (PA-C) list a practice location?
Patients near Colville, Washington may find KELLY LORRAINE WITTE (PA-C) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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