NPIMap

Individual provider Active NPI

Candace M Winters, PA

  • Physician Assistant
  • Gillette, WY
National Provider Identifier
1023130440
Registry record updated Jan 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0645 Issued in SD
Practice address
2201 S Douglas Hwy Ste 120
Gillette, WY 82718-5408
Phone
(800) 446-9556
NPI assigned
Apr 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0645 SD Primary

Addresses

Primary practice location

2201 S Douglas Hwy Ste 120
Gillette, WY 82718-5408

Mailing address

PO Box 6850
Rapid City, SD 57709-6850
Phone (605) 341-1414

Other practice location 1

7220 S Highway 16
Rapid City, SD 57702-8708
Phone (605) 341-1414

Other identifiers 5

IdentifierTypeStateIssuer
1477523678MedicaidSD
6829360MedicaidSD
0645OtherSDLICENSE
9248507OtherSDDAKOTACARE
4993240OtherSDWELLMARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD, WY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20070621000661 SD Practitioner - Physician Assistant 7416056080 Reassigns benefits to 2 organizations
I20161014000783 WY Practitioner - Physician Assistant 7416056080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Sanford School of Medicine of University of South Dakota, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

353 Fairmont Blvd
Rapid City, SD 57701-7375
Phone (605) 755-8109

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1189SDMDMarriage & Family Therapist
1607SDMDPhysical Therapist
0645SDMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Monument Health Rapid City Hospital Inc CurrentSince May 22, 2025 Accepting new patients
Campbell County Hospital District Current Accepting new patients
Campbell County Hospital District CurrentSince Apr 18, 2022 Accepting new patients
Campbell County Hospital District CurrentSince Apr 18, 2022 Accepting new patients
Monument Health Rapid City Hospital, Inc. Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

353 Fairmont Blvd
Rapid City, SD 57701
Phone (605) 719-1000

501 S Burma Ave
Fl 3
Gillette, WY 82716
Phone (307) 688-3636

501 S Burma Ave
Gillette, WY 82716
Phone (307) 682-8811

Interoperability endpoints

  • Direct secure messaging: cwinters@ccmg.gwaydirect.com

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 12

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": "1175731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548115200000",
    "number": "1023130440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6850",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577096850",
            "telephone_number": "605-341-1414",
            "fax_number": "605-341-7062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 S DOUGLAS HWY STE 120",
            "city": "GILLETTE",
            "state": "WY",
            "postal_code": "827185408",
            "telephone_number": "800-446-9556"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7220 S Highway 16",
            "address_purpose": "LOCATION",
            "city": "Rapid City",
            "state": "SD",
            "postal_code": "577028708",
            "country_code": "US",
            "telephone_number": "605-341-1414",
            "fax_number": "605-341-7062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINTERS",
        "first_name": "CANDACE",
        "middle_name": "M",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-05",
        "last_updated": "2019-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0645",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477523678",
            "state": "SD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6829360",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "0645",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAKOTACARE",
            "identifier": "9248507",
            "state": "SD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "4993240",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gillette, WY

Sources for this page

Verify at the official NPI Registry.