Individual provider Active NPI

Stephanie Winter, PA-C

  • Physician Assistant
  • Fort Wainwright, AK
National Provider Identifier
1124326475
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PADA1059 Issued in AK
Practice address
4076 Neely Rd
Fort Wainwright, AK 99703
Phone
(907) 361-4000
Fax
(907) 361-4835
NPI assigned
Mar 10, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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 PADA1059 AK Primary

Addresses

Primary practice location

4076 Neely Rd
Fort Wainwright, AK 99703

Mailing address

4076 Neely Rd
Fort Wainwright, AK 99703
Phone (907) 361-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
653MTMDMassage Therapist
PADA1059AKMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grayling Medical Group LLC PastSince Dec 5, 2021 Accepting new patients

Organizations & group practices 1

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": "1299715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1124326475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4076 NEELY RD",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-361-4000",
            "fax_number": "907-361-4835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4076 NEELY RD",
            "city": "FORT WAINWRIGHT",
            "state": "AK",
            "postal_code": "99703",
            "telephone_number": "907-361-4000",
            "fax_number": "907-361-4835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTER",
        "first_name": "STEPHANIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-10",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AK",
            "license": "PADA1059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wainwright, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.