Individual provider Active NPI

Jennifer L Winingear, LCSW

  • Clinical Social Worker
  • Fulton, MO
National Provider Identifier
1528268885
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2005000399 Issued in MO
Practice address
581 Commons Dr
Fulton, MO 65251
Phone
(573) 582-1234
Fax
(573) 582-1212
NPI assigned
Jul 24, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2005000399 MO Primary

Addresses

Primary practice location

581 Commons Dr
Fulton, MO 65251

Mailing address

581 Commons Dr
Fulton, MO 65251-1408
Phone (573) 582-1234

Other practice location 1

3401 Berrywood Dr Ste 101
Columbia, MO 65201
Phone (573) 777-8455

Other practice location 2

340 Kelley Pkwy
Mexico, MO 65265-3811
Phone (573) 582-1234 ext. 3017

Other identifiers 1

IdentifierTypeStateIssuer
497291716MedicaidMO

Other names 1

  • Jennifer Bristow Former name

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

State licenses

LicenseStateTypeSpecialty
2005000399MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc Clinical Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1528268885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "581 COMMONS DR",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511408",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "581 COMMONS DR",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "65251",
            "telephone_number": "573-582-1234",
            "fax_number": "573-582-1212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3401 Berrywood Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MO",
            "postal_code": "65201",
            "country_code": "US",
            "telephone_number": "573-777-8455",
            "fax_number": "573-777-8455",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "340 Kelley Pkwy",
            "address_purpose": "LOCATION",
            "city": "Mexico",
            "state": "MO",
            "postal_code": "652653811",
            "country_code": "US",
            "telephone_number": "573-582-1234 x3017",
            "fax_number": "573-582-1212",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WININGEAR",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-24",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2005000399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "497291716",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "BRISTOW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fulton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.