Active NPI
Carly Bailey Van Winkle, NP
- Neonatal Nurse Practitioner
- Indianapolis, IN
National Provider Identifier
1669219614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neonatal Nurse Practitioner
- License
- 71015442A
- Practice address
- 705 Riley Hospital Dr
Indianapolis, IN 46202-5109 - Phone
- (317) 274-4779
- Fax
- (317) 948-9806
- NPI assigned
- Jul 9, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal Nurse Practitioner | 363LN0000X | 28243580A | IN | |
| Neonatal Nurse Practitioner | 363LN0000X | 71015442A | IN | Primary |
Addresses
Primary practice location
705 Riley Hospital Dr
Indianapolis, IN 46202-5109
Mailing address
PO Box 778912
Chicago, IL 60677-8912
Phone (317) 777-6435
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 300093223 | Medicaid | IN |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28243580A | IN | MD | Neonatal Nurse Practitioner |
| 71015442A | IN | MD | Neonatal Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Pediatric Associates, Inc. | Current | Accepting new patients |
Locations
705 Riley Hospital Dr
Indianapolis, IN 46202
Phone (317) 274-4779
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Indianapolis, IN
- NPI 1457396541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737331200000",
"number": "1669219614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 778912",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606778912",
"telephone_number": "317-777-6435",
"fax_number": "317-777-6644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 RILEY HOSPITAL DR",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462025109",
"telephone_number": "317-274-4779",
"fax_number": "317-948-9806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN WINKLE",
"first_name": "CARLY",
"middle_name": "BAILEY",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-09",
"last_updated": "2025-01-20",
"certification_date": "2025-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "IN",
"license": "28243580A",
"primary": false
},
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "IN",
"license": "71015442A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "300093223",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.