Active NPI
Timothy Winn
- Counselor
- Broken Arrow, OK
National Provider Identifier
1871883710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- C080846674
- Practice address
- 1410 W Pittsburg PL
Broken Arrow, OK 74012-6656 - Phone
- (918) 521-1405
- NPI assigned
- Apr 12, 2011
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | C080846674 | OK | Primary |
Addresses
Primary practice location
1410 W Pittsburg PL
Broken Arrow, OK 74012-6656
Mailing address
1410 W Pittsburg PL
Broken Arrow, OK 74012-6656
Phone (918) 521-1405
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C080846674 | OK | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305849600000",
"number": "1871883710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1410 W PITTSBURG PL",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740126656",
"telephone_number": "918-521-1405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1410 W PITTSBURG PL",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740126656",
"telephone_number": "918-521-1405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINN",
"first_name": "TIMOTHY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-04-12",
"last_updated": "2011-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OK",
"license": "C080846674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.