Active NPI
Mindy N Meyer, CPNP
- Pediatric Nurse Practitioner
- Winfield, IL
National Provider Identifier
1306118922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 209.009278
- Practice address
- 25 N Winfield Rd
Winfield, IL 60190-1295 - Phone
- (630) 933-6631
- Fax
- (630) 933-4936
- NPI assigned
- Jan 27, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 209.009278 | IL | Primary |
Addresses
Primary practice location
25 N Winfield Rd
Winfield, IL 60190-1295
Mailing address
25 N Winfield Rd
Winfield, IL 60190-1295
Phone (630) 933-6631
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 041341905 | Medicaid | IL | |
| 206147099 | Other | IL | MEDICARE PTAN (INDIVIDUAL) |
| 206147 | Other | IL | MEDICARE PTAN (GROUP) |
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
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.009278 | IL | MD | Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645401600000",
"number": "1306118922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 N WINFIELD RD",
"city": "WINFIELD",
"state": "IL",
"postal_code": "601901295",
"telephone_number": "630-933-6631",
"fax_number": "630-933-4936"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 N WINFIELD RD",
"city": "WINFIELD",
"state": "IL",
"postal_code": "601901295",
"telephone_number": "630-933-6631",
"fax_number": "630-933-4936"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEYER",
"first_name": "MINDY",
"middle_name": "N",
"credential": "CPNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-27",
"last_updated": "2022-02-21",
"certification_date": "2022-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "IL",
"license": "209.009278",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "041341905",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN (INDIVIDUAL)",
"identifier": "206147099",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN (GROUP)",
"identifier": "206147",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winfield, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.