Individual provider Active NPI

Lacey Rose Winkel, FNP-C

  • Family Nurse Practitioner
  • Spanish Fork, UT
National Provider Identifier
1003517913
Registry record updated May 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
7853161-4405 Issued in UT
Practice address
972 N 600 E
Spanish Fork, UT 84660-1306
Phone
(801) 465-4896
Fax
(801) 465-3267
NPI assigned
Mar 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 7853161-4405 UT
Family Nurse Practitioner 363LF0000X 7853161-4405 UT Primary

Addresses

Primary practice location

972 N 600 E
Spanish Fork, UT 84660-1306

Mailing address

1055 N 500 W
Att: Credentialing
Provo, UT 84604
Phone (801) 354-8225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230517001895 UT Practitioner - Nurse Practitioner 3870959869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

972 N 600
Spanish Fork, UT 84660-1306
Phone (801) 374-1268

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7853161-4405UTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince May 30, 2023 Accepting new patients
Revere Health PC CurrentSince May 30, 2023 Accepting new patients

Locations

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

972 N 600 E
Spanish Fork, UT 84660
Phone (385) 265-6060

Interoperability endpoints

  • Direct secure messaging: laceywinkel@cuccu.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1003517913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATT: CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "972 N 600 E",
            "city": "SPANISH FORK",
            "state": "UT",
            "postal_code": "846601306",
            "telephone_number": "801-465-4896",
            "fax_number": "801-465-3267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINKEL",
        "first_name": "LACEY",
        "middle_name": "ROSE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-16",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "7853161-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7853161-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spanish Fork, UT

Sources for this page

Verify at the official NPI Registry.