Individual provider Active NPI

Elizabeth Marie Van Winkle, M.S.

  • Speech-Language Pathologist
  • Omaha, NE
National Provider Identifier
1154679710
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
1582 Issued in NE
Practice address
8303 Dodge St
Suite 304
Omaha, NE 68114-4108
Phone
(402) 354-5048
Fax
(402) 354-2585
NPI assigned
Aug 29, 2012
Last updated
Dec 13, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 002236 IA
Speech-Language Pathologist 235Z00000X 1582 NE Primary

Addresses

Primary practice location

8303 Dodge St
Suite 304
Omaha, NE 68114-4108

Mailing address

PO Box 10190
Virginia Beach, VA 23450-0190
Phone (800) 477-5240

Other identifiers 3

IdentifierTypeStateIssuer
10026075400MedicaidNE
1582OtherNENE LICENSE
002236OtherIAIA LICENSE

Other names 1

  • Elizabeth Marie Crowley Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130912000233 NE Practitioner - Qualified Speech Language Pathologist 4082858055 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
002236IAMDOccupational Therapist
1582NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nebraska Methodist Hospital CurrentSince Jun 17, 2013 Accepting new patients

Locations

8303 Dodge St
Ste 304
Omaha, NE 68114
Phone (402) 354-4104

8601 W Dodge Rd
Ste 216
Omaha, NE 68114
Phone (402) 354-4822

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, 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": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386892800000",
    "number": "1154679710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10190",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234500190",
            "telephone_number": "800-477-5240",
            "fax_number": "757-463-6572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8303 DODGE ST",
            "address_2": "SUITE 304",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144108",
            "telephone_number": "402-354-5048",
            "fax_number": "402-354-2585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WINKLE",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2013-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IA",
            "license": "002236",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NE",
            "license": "1582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10026075400",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NE LICENSE",
            "identifier": "1582",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IA LICENSE",
            "identifier": "002236",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "CROWLEY",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.