Individual provider Active NPI

Nadine Marie Woinoski

  • Community/Behavioral Health Agency
  • Fort Myers, FL
National Provider Identifier
1306242276
Registry record updated Nov 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
1073871208 Issued in FL
Practice address
3049 Cleveland Ave
Suite 269
Fort Myers, FL 33901-7041
Phone
(703) 424-0354
NPI assigned
Nov 5, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 1073871208 FL Primary

Addresses

Primary practice location

3049 Cleveland Ave
Suite 269
Fort Myers, FL 33901-7041

Mailing address

1243 Slash Pine Cir
#124
Punta Gorda, FL 33950-2292
Phone (941) 286-8897

Other identifiers 1

IdentifierTypeStateIssuer
011132100MedicaidFL

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1073871208FLMDCommunity/Behavioral Health Agency

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415145600000",
    "number": "1306242276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 SLASH PINE CIR",
            "address_2": "#124",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339502292",
            "telephone_number": "941-286-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3049 CLEVELAND AVE",
            "address_2": "SUITE 269",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017041",
            "telephone_number": "703-424-0354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOINOSKI",
        "first_name": "NADINE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-05",
        "last_updated": "2014-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "FL",
            "license": "1073871208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011132100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2014; 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.