Individual provider Active NPI

Laura Kailey Winkleblack, CRNP

  • Acute Care Nurse Practitioner
  • Phoenix, AZ
National Provider Identifier
1134446552
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP4521 Issued in AZ
Practice address
1441 N 12TH St FL 2
Phoenix, AZ 85006-2837
Phone
(602) 839-6040
Fax
(602) 839-3411
NPI assigned
Apr 24, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 011021 PA
Orthopedic Registered Nurse 163WX0800X RN594783 PA
Acute Care Nurse Practitioner 363LA2100X AP4521 AZ Primary

Addresses

Primary practice location

1441 N 12TH St FL 2
Phoenix, AZ 85006-2837

Mailing address

1441 N 12TH St FL 2
Phoenix, AZ 85006-2837
Phone (602) 839-6040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20121017000354 AZ Practitioner - Nurse Practitioner 7911195821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Banner - University Physician Specialists LLCGroup PAC ID 5991008054, 343 clinicians

Practice addresses (Care Compare)

1441 N 12TH St
FL 2
Phoenix, AZ 85006-2837
Phone (844) 242-4664

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
69.75
Promoting interoperability
98
Improvement activities
40
Cost
68.18

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011021PAMDRegistered Nurse
RN594783PAMDOrthopedic Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Jan 18, 2021 Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Jan 18, 2021 Accepting new patients
Reconstructive Orthopaedic Associates II LLC Past Accepting new patients

Locations

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1441 N 12th St
Fl 3
Phoenix, AZ 85006
Phone (602) 521-5700

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

1441 N 12th St
Fl 2
Phoenix, AZ 85006
Phone (602) 521-5180

4200 E Camelback Rd
Ste 202
Phoenix, AZ 85018
Phone (602) 229-2150

Organizations & group practices 3

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 1

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": "1272067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1134446552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-839-6040",
            "fax_number": "602-839-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-839-6040",
            "fax_number": "602-839-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINKLEBLACK",
        "first_name": "LAURA",
        "middle_name": "KAILEY",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-24",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "011021",
            "primary": false
        },
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "PA",
            "license": "RN594783",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AZ",
            "license": "AP4521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.