Individual provider Active NPI

Reginald Patrick Wince Sr., NP-C

  • Adult Health Nurse Practitioner
  • Centreville, IL
National Provider Identifier
1417129693
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
209005440 Issued in IL
Practice address
5900 Bond Ave
Centreville, IL 62207-2326
Phone
(618) 332-3060
Fax
(618) 332-5297
NPI assigned
Mar 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 209005440 IL Primary

Addresses

Primary practice location

5900 Bond Ave
Centreville, IL 62207-2326

Mailing address

32 Hi Pointe Dr
Belleville, IL 62223-7119
Phone (618) 398-8482

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080502000649 IL Practitioner - Nurse Practitioner 7618056508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Touchette Regional Hospital IncGroup PAC ID 7416843370, 46 clinicians

Practice addresses (Care Compare)

2071 Goose Lake Rd
Sauget, IL 62206-2822
Phone (618) 857-2700

5900 Bond Ave
Cahokia Heights, IL 62207-2326
Phone (618) 332-3060

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Touchette Regional Hospital Inc CurrentSince Jun 1, 2019 Accepting new patients

Locations

5900 Bond Ave
East Saint Louis, IL 62207
Phone (618) 332-3060

2071 Goose Lake Rd
Sauget, IL 62206
Phone (314) 872-1473

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1206662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1417129693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 HI POINTE DR",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622237119",
            "telephone_number": "618-398-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 BOND AVE",
            "city": "CENTREVILLE",
            "state": "IL",
            "postal_code": "622072326",
            "telephone_number": "618-332-3060",
            "fax_number": "618-332-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINCE",
        "first_name": "REGINALD",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-28",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "IL",
            "license": "209005440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, IL

Sources for this page

Verify at the official NPI Registry.