Individual provider Active NPI

Debra Lynn Winkeljohn, CNS

  • Oncology Clinical Nurse Specialist
  • Albuquerque, NM
National Provider Identifier
1619164589
Registry record updated Mar 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oncology Clinical Nurse SpecialistTaxonomy code 364SX0200X
License
CNS00101 Issued in NM
Practice address
4901 Lang Ave NE
Albuquerque, NM 87109-4495
Phone
(505) 842-8171
Fax
(505) 246-0684
NPI assigned
Sep 25, 2007
Last updated
Mar 3, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oncology Clinical Nurse Specialist 364SX0200X CNS00101 NM Primary

Addresses

Primary practice location

4901 Lang Ave NE
Albuquerque, NM 87109-4495

Mailing address

715 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3661
Phone (505) 727-3040

Other practice location 1

715 Dr Martin Luther King Jr Ave NE
Albuquerque, NM 87102-3661
Phone (505) 727-3040

Other identifiers 1

IdentifierTypeStateIssuer
59509074MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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
I20071120000627 NM Practitioner - Certified Clinical Nurse Specialist (CNS) 4082702378 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
CNS00101NMMDOncology Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lovelace Health System, LLC CurrentSince Jul 1, 2013 Accepting new patients
New Mexico Oncology Hematology Consultants, LTD. CurrentSince Mar 1, 2020 Accepting new patients
Lovelace Health System LLC Current Accepting new patients
Lovelace Health System, LLC CurrentSince Jul 1, 2013 Accepting new patients
Optumcare New Mexico LLC PastSince Jun 1, 2006 Accepting new patients

Locations

10501 Golf Course Rd NW
Albuquerque, NM 87114
Phone (505) 727-2000

4701 Montgomery Blvd NE
Albuquerque, NM 87109
Phone (505) 727-2000

4901 Lang Ave NE
Albuquerque, NM 87109
Phone (505) 828-3877

5400 Gibson Blvd SE
Albuquerque, NM 87108
Phone (505) 262-7174

601 Martin Luther King Ave NE
Albuquerque, NM 87102
Phone (505) 727-8040

715 Martin Luther King Ave NE
Ste 301
Albuquerque, NM 87102
Phone (505) 727-4500

2240 College Dr
Gallup, NM 87301
Phone (505) 297-1052

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1619164589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 DR MARTIN LUTHER KING JR AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871023661",
            "telephone_number": "505-727-3040",
            "fax_number": "505-727-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 LANG AVE NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871094495",
            "telephone_number": "505-842-8171",
            "fax_number": "505-246-0684"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "715 Dr Martin Luther King Jr Ave NE",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871023661",
            "country_code": "US",
            "telephone_number": "505-727-3040",
            "fax_number": "505-727-3099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINKELJOHN",
        "first_name": "DEBRA",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-25",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SX0200X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Oncology",
            "state": "NM",
            "license": "CNS00101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "59509074",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.