Individual provider Active NPI

Ian Patrick Winter, RDN

  • Registered Dietitian
  • Norfolk, VA
National Provider Identifier
1811630635
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
86292737 Issued in VA
Practice address
115 College PL Ste a
Norfolk, VA 23510-1930
Phone
(757) 605-8181
NPI assigned
Apr 19, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86292737 VA Primary

Addresses

Primary practice location

115 College PL Ste a
Norfolk, VA 23510-1930

Mailing address

1153 Kings Way Dr
Virginia Beach, VA 23455-5535
Phone (757) 605-8181

Other practice location 1

848 First Colonial Rd Ste B
Virginia Beach, VA 23451-6126
Phone (757) 422-4728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220527001922 VA Practitioner - Registered Dietitian Or Nutrition Professional 0547648891 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
86292737VAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
JWF Nutrition, LLC Dietitian, Registered CurrentSince Apr 27, 2022 Accepting new patients
Nourish, Inc. Dietitian, Registered Past Accepting new patients

Locations

115 College Pl
Ste A
Norfolk, VA 23510
Phone (757) 340-3200

848 First Colonial Rd
#B
Virginia Beach, VA 23451
Phone (757) 422-4725

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1811630635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 KINGS WAY DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234555535",
            "telephone_number": "757-605-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 COLLEGE PL STE A",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235101930",
            "telephone_number": "757-605-8181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "848 First Colonial Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234516126",
            "country_code": "US",
            "telephone_number": "757-422-4728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINTER",
        "first_name": "IAN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "RDN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "VA",
            "license": "86292737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.