Individual provider Active NPI

Blaine Michael Winterton, DO

  • Pulmonary Disease Physician
  • Fort Smith, AR
National Provider Identifier
1154983237
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
E-19090 Issued in AR
Practice address
2713 S 74TH St Ste 301
Fort Smith, AR 72903-5155
Phone
(479) 314-4620
Fax
(479) 314-4630
NPI assigned
Jun 28, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 2022021013 MO
Pulmonary Disease Physician 207RP1001X E-19090 AR Primary
Internal Medicine Physician 207R00000X 2019021801 MO

Addresses

Primary practice location

2713 S 74TH St Ste 301
Fort Smith, AR 72903-5155

Mailing address

PO Box 776084
Chicago, IL 60677-6084
Phone (479) 314-4620

Other practice location 1

1 Hospital Dr # Dc043.00
Columbia, MO 65212-1000
Phone (573) 884-1606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, AR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240923000116 MO Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 4587992318 Reassigns benefits to 1 organization
I20250729004644 AR Practitioner - Pulmonary Disease 4587992318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary Disease
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2713 S 74TH St
Suite 301
Fort Smith, AR 72903-5155
Phone (479) 314-4620

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
E-19090ARMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Fort Smith Communities CurrentSince Jul 18, 2025 Accepting new patients
Boone Physician Services, LLC CurrentSince Oct 21, 2024 Accepting new patients
Mercy Clinic Fort Smith Communities CurrentSince Jul 18, 2025 Accepting new patients

Locations

7001 Rogers Ave
Ste 200
Fort Smith, AR 72903
Phone (479) 314-4620

2713 S 74th St
Ste 301
Fort Smith, AR 72903
Phone (479) 314-4620

1600 E Broadway
Columbia, MO 65201
Phone (573) 632-5000

1705 E Broadway
Ste 280
Columbia, MO 65201
Phone (573) 815-7119

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 2

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": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1154983237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776084",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776084",
            "telephone_number": "479-314-4620",
            "fax_number": "479-314-4630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2713 S 74TH ST STE 301",
            "city": "FORT SMITH",
            "state": "AR",
            "postal_code": "729035155",
            "telephone_number": "479-314-4620",
            "fax_number": "479-314-4630"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Hospital Dr # Dc043.00",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "652121000",
            "country_code": "US",
            "telephone_number": "573-884-1606",
            "fax_number": "573-884-4533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINTERTON",
        "first_name": "BLAINE",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-28",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MO",
            "license": "2022021013",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "AR",
            "license": "E-19090",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2019021801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Smith, AR

Sources for this page

Verify at the official NPI Registry.