Active NPI
Stephen Lee Winston, MD
- Interventional Pain Medicine Physician
- Grand Rapids, MI
National Provider Identifier
1376509158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- License
- 4301052549
- Practice address
- 2060 East Paris Ave SE Ste 200
Grand Rapids, MI 49546-6113 - Phone
- (616) 285-1377
- Fax
- (616) 285-1154
- NPI assigned
- Apr 21, 2006
- Last updated
- May 10, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 4301052549 | MI | |
| Interventional Pain Medicine Physician | 208VP0014X | 4301052549 | MI | Primary |
Addresses
Primary practice location
2060 East Paris Ave SE Ste 200
Grand Rapids, MI 49546-6113
Mailing address
5555 Glenwood Hills Pkwy SE Ste 2
Grand Rapids, MI 49512-2091
Phone (616) 940-2662
Other identifiers 13
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 175881 | Other | US DEPT OF LABOR | |
| 24278 | Other | HEALTH PLAN OF MICHIGAN | |
| 4467217 | Other | AETNA | |
| 4532369-10 | Medicaid | MI | |
| 550410620 | Other | MI | BCBSM |
| 504646 | Other | PREFERRED CHOICES | |
| 5211643-10 | Medicaid | MI | |
| 7000027111 | Other | PRIORITY HEALTH | |
| 050059838 | Other | RAILROAD MEDICARE | |
| 4552960-10 | Medicaid | MI | |
| 3240684 | Other | CIGNA | |
| 4593079-10 | Medicaid | MI | |
| 7000027111 | Other | PRIORITY HEALTH MEDICAID |
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
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620604800000",
"number": "1376509158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5555 GLENWOOD HILLS PKWY SE STE 2",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495122091",
"telephone_number": "616-940-2662",
"fax_number": "616-940-1965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2060 EAST PARIS AVE SE STE 200",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495466113",
"telephone_number": "616-285-1377",
"fax_number": "616-285-1154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINSTON",
"first_name": "STEPHEN",
"middle_name": "LEE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-21",
"last_updated": "2021-05-10",
"certification_date": "2021-05-10",
"status": "A"
},
"taxonomies": [
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "MI",
"license": "4301052549",
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "MI",
"license": "4301052549",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF LABOR",
"identifier": "175881",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTH PLAN OF MICHIGAN",
"identifier": "24278",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4467217",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4532369-10",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM",
"identifier": "550410620",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CHOICES",
"identifier": "504646",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5211643-10",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY HEALTH",
"identifier": "7000027111",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "050059838",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4552960-10",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3240684",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4593079-10",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY HEALTH MEDICAID",
"identifier": "7000027111",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.