Kitzy Lillie Winn

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

840994 Issued in NV

Practice address

1707 W Charleston Blvd Ste 110
Las Vegas, NV 89102-2352

Phone

(702) 650-2500

NPI assigned

Dec 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Unlv Medicine

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1407397235
  Medicare reassignment NPD
• Unlv Medicine

  • Community/Retail Pharmacy
  • Las Vegas, NV
  • NPI 1184152274
  NPD
• Lubbock County Hospital District

  • General Acute Care Hospital
  • Lubbock, TX
  • NPI 1821087164
  NPD (past)

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

{
    "created_epoch": "1640649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1033879499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3016 W CHARLESTON BLVD STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891021973",
            "telephone_number": "702-650-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 W CHARLESTON BLVD STE 110",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891022352",
            "telephone_number": "702-650-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3333 W Tech Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-641-5725",
            "fax_number": "937-350-3050",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8501 Old Troy Pike",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241054",
            "country_code": "US",
            "telephone_number": "937-641-4360",
            "fax_number": "937-641-3791",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Childrens Plz",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454041815",
            "country_code": "US",
            "telephone_number": "937-641-3600",
            "fax_number": "937-641-5802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 W Tech Rd",
            "address_purpose": "LOCATION",
            "city": "Miamisburg",
            "state": "OH",
            "postal_code": "453420955",
            "country_code": "US",
            "telephone_number": "937-641-3400",
            "fax_number": "937-641-4880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8809 Wilkens Blvd",
            "address_purpose": "LOCATION",
            "city": "Mason",
            "state": "OH",
            "postal_code": "450407390",
            "country_code": "US",
            "telephone_number": "513-701-6907",
            "fax_number": "513-204-0292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3301 Dayton Xenia Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454322759",
            "country_code": "US",
            "telephone_number": "937-641-5098",
            "fax_number": "937-912-9395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7787 Cox Ln",
            "address_purpose": "LOCATION",
            "city": "West Chester",
            "state": "OH",
            "postal_code": "450696549",
            "country_code": "US",
            "telephone_number": "513-644-8081",
            "fax_number": "513-847-1192",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "662 N Main St",
            "address_purpose": "LOCATION",
            "city": "Springboro",
            "state": "OH",
            "postal_code": "450669553",
            "country_code": "US",
            "telephone_number": "937-641-5066",
            "fax_number": "937-550-9797",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINN",
        "first_name": "KITZY",
        "middle_name": "LILLIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-28",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "OH",
            "license": "APRN.CNP.0027756",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "OH",
            "license": "APRN.CNP.0027756",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "PA",
            "license": "SP025082",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NV",
            "license": "840994",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0481203",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brody Winn, M.D.
• Carlotta Denise Winn
• David Winn
• Kashari Winn
• Kaye Dawn Winn
• Michael Winn
• Pamela Jean Winn, APRN
• Rochelle Shamar Winn
• Winna Pham DDS PLLC
• Judy Winreb, MA, MFT, LADC

• Pediatric Nurse Practitioner in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Pediatric Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.