Active NPI
Joel Gregory Winner, M.D.
- Psychiatry Physician
- Boulder, CO
National Provider Identifier
1356550131
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 50740
- Practice address
- 2595 Canyon Blvd
Suite 100
Boulder, CO 80302-6745 - Phone
- (720) 920-9174
- Fax
- (720) 920-9307
- NPI assigned
- May 21, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 13772 | HI | |
| Psychiatry Physician | 2084P0800X | 50740 | MN | Primary |
| Psychiatry Physician | 2084P0800X | 47729 | CO |
Addresses
Primary practice location
2595 Canyon Blvd
Suite 100
Boulder, CO 80302-6745
Mailing address
2595 Canyon Blvd
Suite 100
Boulder, CO 80302-6745
Phone (720) 920-9174
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ENROLLED | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2021 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 47729 | CO | MD | Psychiatry Physician |
| 13772 | HI | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179705600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248134400000",
"number": "1356550131",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2595 CANYON BLVD",
"address_2": "SUITE 100",
"city": "BOULDER",
"state": "CO",
"postal_code": "803026745",
"telephone_number": "720-920-9174",
"fax_number": "720-920-9307"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2595 CANYON BLVD",
"address_2": "SUITE 100",
"city": "BOULDER",
"state": "CO",
"postal_code": "803026745",
"telephone_number": "720-920-9174",
"fax_number": "720-920-9307"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINNER",
"first_name": "JOEL",
"middle_name": "GREGORY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-21",
"last_updated": "2009-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "HI",
"license": "13772",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MN",
"license": "50740",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CO",
"license": "47729",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ENROLLED",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.