Stacey Leigh Winters, D.O

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DO173291 Issued in OR

Practice address

2700 SE Stratus Ave Unit 405
McMinnville, OR 97128-6258

Phone

(971) 287-5111

Fax

(503) 472-0127

NPI assigned

Feb 17, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Memorial Hospital of Laramie County

  • General Acute Care Hospital
  • Cheyenne, WY
  • NPI 1285621839
  Medicare reassignment NPD

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1619942331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 SE STRATUS AVE",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286255",
            "telephone_number": "971-287-5111",
            "fax_number": "503-472-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 SE STRATUS AVE UNIT 405",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971286258",
            "telephone_number": "971-287-5111",
            "fax_number": "503-472-0127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINTERS",
        "first_name": "STACEY",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "OP60176915",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "DO173291",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619942331",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KRMC L&I GROUP NUMBER",
            "identifier": "025904",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shedlund946653@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "725 S Wahanna Rd Ste 230",
            "city": "Seaside",
            "state": "OR",
            "country_code": "US",
            "postal_code": "971387735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kayla Renae Winkler, MOT
• J'Deanna Winn, MA
• Nicole Patrice Winnen, R.PH.
• Arri Corvaine Winter
• Molly Winterrowd
• Helen Woldemariam
• Gerald Leon Wolf, FNAO
• Natasha Wong, PSY.D.
• Suzanne Wong
• Emily Kay Wood, P.T.

• Pediatrics Physician in McMinnville, OR
• Providers in McMinnville, OR by specialty
• Pediatrics Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.