Individual provider Active NPI

Jennifer Winborne, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Paoli, PA
National Provider Identifier
1538934450
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
SP028744 Issued in PA
Practice address
2 Industrial Blvd Ste 200
Paoli, PA 19301-1648
Phone
(610) 647-2400
Fax
(610) 647-3902
NPI assigned
Nov 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X SP028744 PA Primary

Addresses

Primary practice location

2 Industrial Blvd Ste 200
Paoli, PA 19301-1648

Mailing address

207 N Broad St FL 3
Philadelphia, PA 19107-1500
Phone (610) 647-2400

Other identifiers 1

IdentifierTypeStateIssuer
1042646540002MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231215001521 PA Practitioner - Nurse Practitioner 5395194351 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiology Consultants of Philadelphia PCGroup PAC ID 5294620746, 154 clinicians

Practice addresses (Care Compare)

1703 S Broad St
Suite 300
Philadelphia, PA 19148-1536
Phone (215) 463-5333

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP028744PAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Main Line Healthcare CurrentSince Dec 7, 2023 Accepting new patients
Cardiology Consultants of Philadelphia, P.C. CurrentSince Feb 3, 2025 Accepting new patients
Tower Health Medical Group Past Accepting new patients

Locations

130 S Bryn Mawr Ave
Rm 459
Bryn Mawr, PA 19010

255 W Lancaster Ave
Paoli, PA 19301
Phone (484) 337-4286

2 Industrial Blvd
Ste 200
Paoli, PA 19301
Phone (610) 647-4260

207 N Broad St
Fl 3
Philadelphia, PA 19107
Phone (215) 361-5020

1703 S Broad St
Ste 300
Philadelphia, PA 19148
Phone (215) 462-7100

100 E Lancaster Ave
Wynnewood, PA 19096
Phone (484) 337-3583

Organizations & group practices 3

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 6

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": "1700524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1538934450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 N BROAD ST FL 3",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071500",
            "telephone_number": "610-647-2400",
            "fax_number": "610-647-3902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 INDUSTRIAL BLVD STE 200",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011648",
            "telephone_number": "610-647-2400",
            "fax_number": "610-647-3902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINBORNE",
        "first_name": "JENNIFER",
        "credential": "AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-21",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "PA",
            "license": "SP028744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1042646540002",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.