Individual provider Active NPI

Kelly Winters, NP

  • Pediatric Nurse Practitioner
  • Torrance, CA
National Provider Identifier
1396091203
Registry record updated Sep 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
95007158 Issued in CA
Practice address
1000 W Carson St
Torrance, CA 90502-2004
Phone
(310) 222-3500
NPI assigned
Jul 28, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 796184 CA
Pediatric Nurse Practitioner 363LP0200X 95007158 CA Primary

Addresses

Primary practice location

1000 W Carson St
Torrance, CA 90502-2004

Mailing address

1000 W Carson St
Torrance, CA 90502-2004
Phone (310) 222-3500

Other names 1

  • Miss Kelly Winters Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230321002121 CA Practitioner - Nurse Practitioner 5890045686 Reassigns benefits to 2 organizations
I20231027000538 DC Practitioner - Nurse Practitioner 5890045686 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
796184CAMDPsychiatric/Mental Health Registered Nurse
95007158CAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mep Health, LLC CurrentSince Oct 1, 2023 Accepting new patients
Pinnacle Emergency Physicians of Bakersfield, a Professional Corp CurrentSince Nov 1, 2022 Accepting new patients
Pinnacle Emergency Physicians of Bakersfield, a Professional Corp CurrentSince Nov 1, 2022 Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

9901 Medical Center Dr
Rockville, MD 20850
Phone (301) 279-6000

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663372800000",
    "number": "1396091203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "310-222-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W CARSON ST",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022004",
            "telephone_number": "310-222-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTERS",
        "first_name": "KELLY",
        "name_prefix": "Miss",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-28",
        "last_updated": "2022-09-17",
        "certification_date": "2022-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "796184",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CA",
            "license": "95007158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "WINTERS",
            "prefix": "MISS",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.