Active NPI
Hayden Paulette Winjum
- Assisted Living Facility
- Crookston, MN
National Provider Identifier
1407678568
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 10859111
- Practice address
- 724 Stuart Ave
Crookston, MN 56716-1665 - Phone
- (218) 289-4323
- NPI assigned
- Oct 29, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 10859111 | MN | Primary |
Addresses
Primary practice location
724 Stuart Ave
Crookston, MN 56716-1665
Mailing address
2951 24TH Ave S Apt 116
Grand Forks, ND 58201-6159
Phone (218) 289-4323
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10859111 | MN | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730160000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730160000000",
"number": "1407678568",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2951 24TH AVE S APT 116",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582016159",
"telephone_number": "218-289-4323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "724 STUART AVE",
"city": "CROOKSTON",
"state": "MN",
"postal_code": "567161665",
"telephone_number": "218-289-4323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINJUM",
"first_name": "HAYDEN",
"middle_name": "PAULETTE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-29",
"last_updated": "2024-10-29",
"certification_date": "2024-10-29",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "MN",
"license": "10859111",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crookston, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.