Active NPI
Walter Richard Vanwinkle, RPH
- Pharmacotherapy Pharmacist
- Three Rivers, MI
National Provider Identifier
1639589500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 5302 410942
- Practice address
- 800 S US Highway 131
Three Rivers, MI 49093-8819 - Phone
- (269) 279-1200
- Fax
- (269) 279-1235
- NPI assigned
- May 1, 2014
- Last updated
- May 1, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 5302 410942 | MI | Primary |
Addresses
Primary practice location
800 S US Highway 131
Three Rivers, MI 49093-8819
Mailing address
800 S US Highway 131
Three Rivers, MI 49093-8819
Phone (269) 279-1200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302 410942 | Other | MI | STATE OF MICHIGAN PHARMACY LICENSE |
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)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302 410942 | MI | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398902400000",
"number": "1639589500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 S US HIGHWAY 131",
"city": "THREE RIVERS",
"state": "MI",
"postal_code": "490938819",
"telephone_number": "269-279-1200",
"fax_number": "269-279-1235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 S US HIGHWAY 131",
"city": "THREE RIVERS",
"state": "MI",
"postal_code": "490938819",
"telephone_number": "269-279-1200",
"fax_number": "269-279-1235"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANWINKLE",
"first_name": "WALTER",
"middle_name": "RICHARD",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-05-01",
"last_updated": "2014-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "MI",
"license": "5302 410942",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF MICHIGAN PHARMACY LICENSE",
"identifier": "5302 410942",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Three Rivers, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.