Individual provider Active NPI

Makenzie Vanwinkle, OT

  • Occupational Therapist
  • Gilbert, AZ
National Provider Identifier
1376158618
Registry record updated Sep 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OTH007542 Issued in AZ
Practice address
1355 N Greenfield Rd
Gilbert, AZ 85234-2813
Phone
(833) 224-5538
Fax
(833) 424-5538
NPI assigned
Sep 14, 2020
Last updated
Sep 14, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OTH007542 AZ Primary

Addresses

Primary practice location

1355 N Greenfield Rd
Gilbert, AZ 85234-2813

Mailing address

1355 N Greenfield Rd
Gilbert, AZ 85234-2813
Phone (833) 224-5538

Other identifiers 1

IdentifierTypeStateIssuer
OTH007542OtherAZLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230808000749 AZ Practitioner - Occupational Therapist in Private Practice 3375904360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
White Mountain Physical Therapy LTDGroup PAC ID 0446142111, 15 clinicians

Practice addresses (Care Compare)

4830 Hwy 260 105
Lakeside, AZ 85929-5851
Phone (928) 532-1221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OTH007542AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
White Mountain Physical Therapy LTD Occupational Therapist CurrentSince Jun 26, 2023 Accepting new patients
Intuitive Women's Health, PLLC Occupational Therapist Current Accepting new patients

Locations

4830 Highway 260
Ste 105
Lakeside, AZ 85929
Phone (928) 532-1221

29 W McNeil
Show Low, AZ 85901
Phone (928) 537-8196

Organizations & group practices 2

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": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600041600000",
    "number": "1376158618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 N GREENFIELD RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342813",
            "telephone_number": "833-224-5538",
            "fax_number": "833-424-5538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 N GREENFIELD RD",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852342813",
            "telephone_number": "833-224-5538",
            "fax_number": "833-424-5538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWINKLE",
        "first_name": "MAKENZIE",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2020-09-14",
        "certification_date": "2020-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "OTH007542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "OTH007542",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.