Individual provider Active NPI

Kim Brigitte Winson, CPNP

  • Pediatric Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1730229824
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
26187 Issued in SC
Practice address
4650 Broad River Rd
Columbia, SC 29210-4016
Phone
(803) 896-9460
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 197336 NC
Pediatric Nurse Practitioner 363LP0200X 26187 SC Primary
Nurse Practitioner 363L00000X 197336 NC

Addresses

Primary practice location

4650 Broad River Rd
Columbia, SC 29210-4016

Mailing address

4650 Broad River Rd
Columbia, SC 29210-4016
Phone (803) 896-9460

Other names 1

  • Ms. Kim Thi-Thien Nguyen Former name

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
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
197336NCMDPediatric Nurse Practitioner
26187SCMDPediatric Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1730229824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4650 BROAD RIVER RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292104016",
            "telephone_number": "803-896-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4650 BROAD RIVER RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292104016",
            "telephone_number": "803-896-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINSON",
        "first_name": "KIM",
        "middle_name": "BRIGITTE",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "197336",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "26187",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "197336",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "NGUYEN",
            "middle_name": "THI-THIEN",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.