Jodi M Kintzle-Wynn, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

110903 Issued in NE

Practice address

4920 So 30TH Street
Suite 103
Omaha, NE 68107-1656

Phone

(402) 734-4110

Fax

(402) 734-3990

NPI assigned

Nov 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jodi M Kintzle Other name

Medicare fee-for-service enrollment

Enrolled in NE

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Oneworld Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Omaha, NE
  • NPI 1952330649
  Medicare reassignment NPD
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Omaha, NE
  • NPI 1548287907
  NPD (past)
• Charles Drew Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Omaha, NE
  • NPI 1386218212
  NPD (past)
• Alegent Creighton Clinic

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1598811069
  NPD (past)
• Alegent Health Quick Care LLC

  • Family Medicine Physician
  • Council Bluffs, IA
  • NPI 1083139224
  NPD (past)

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

{
    "created_epoch": "1195171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1629259817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 SO 30TH STREET",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071656",
            "telephone_number": "402-734-4110",
            "fax_number": "402-734-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 SO 30TH STREET",
            "address_2": "SUITE 103",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071656",
            "telephone_number": "402-734-4110",
            "fax_number": "402-734-3990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINTZLE-WYNN",
        "first_name": "JODI",
        "middle_name": "M",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-16",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NE",
            "license": "110903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JODI",
            "last_name": "KINTZLE",
            "middle_name": "M",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mary Elizabeth Kinnison
• Theresa Kinnison
• Tina Renee Kinsley, MD
• Robert George Kinsman, PT
• Kimber Ann Kinstler, LIMHP
• Katie Kintzle, RN
• Kaylee Marie Kintzle
• Mary Wulff Kinyoun, M.D.
• Stacey Kinzle
• Tyson Kinzle

• Family Nurse Practitioner in Omaha, NE
• Providers in Omaha, NE by specialty
• Family Nurse Practitioner in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.