Individual provider Active NPI

Jennifer L. Vanwinkle, NP

  • Family Nurse Practitioner
  • Pueblo West, CO
National Provider Identifier
1053685081
Registry record updated Jun 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
990344 Issued in CO
Practice address
1538 W Camino de Los Ranchos
Pueblo West, CO 81007-2040
Phone
(719) 359-6257
NPI assigned
Mar 8, 2012
Last updated
Jun 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 990344 CO
Family Nurse Practitioner 363LF0000X 990344 CO Primary

Addresses

Primary practice location

1538 W Camino de Los Ranchos
Pueblo West, CO 81007-2040

Mailing address

2 South Cascade Avenue
Suite 140
Colorado Springs, CO 80903-1604
Phone (719) 538-2900

Other identifiers 2

IdentifierTypeStateIssuer
76720063MedicaidCO
259444ZL1POtherCOMEDICARE ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20120726000617 CO Practitioner - Nurse Practitioner 4587820006 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
990344COMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nuvoair Medical PC CurrentSince May 7, 2023 Accepting new patients
Nuvoair Medical PC CurrentSince May 7, 2023 Accepting new patients

Locations

5723 E 5th St
Tucson, AZ 85711
Phone (520) 514-7400

50 Milk St
Fl 16
Boston, MA 02109
Phone (617) 213-0335

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27550/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jennifer.van.winkle.1@27550.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686614400000",
    "number": "1053685081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SOUTH CASCADE AVENUE",
            "address_2": "SUITE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809031604",
            "telephone_number": "719-538-2900",
            "fax_number": "719-538-2961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1538 W CAMINO DE LOS RANCHOS",
            "city": "PUEBLO WEST",
            "state": "CO",
            "postal_code": "810072040",
            "telephone_number": "719-359-6257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWINKLE",
        "first_name": "JENNIFER",
        "middle_name": "L.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-08",
        "last_updated": "2023-06-13",
        "certification_date": "2023-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CO",
            "license": "990344",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "990344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "76720063",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "259444ZL1P",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo West, CO

Sources for this page

Verify at the official NPI Registry.