Individual provider Active NPI

Timothy Eric Vanwinkle, NP

  • Family Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1922018167
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
221156 Issued in LA
Practice address
1747 Imperial Blvd
Lake Charles, LA 70605-5362
Phone
(337) 721-7236
Fax
(337) 721-7237
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Registered Nurse 163WX0800X RN84018 LA
Family Nurse Practitioner 363LF0000X 221156 LA Primary

Addresses

Primary practice location

1747 Imperial Blvd
Lake Charles, LA 70605-5362

Mailing address

1747 Imperial Blvd
Lake Charles, LA 70605-5362

Other identifiers 2

IdentifierTypeStateIssuer
221156OtherLAMEDICAL LICENSE
RN84018OtherLASTATE LICENSE #

Other names 1

  • Mr. Timothy Eric Van Winkle Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210819000673 LA Practitioner - Nurse Practitioner 4183029846 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for Orthopaedics and Spine LLCGroup PAC ID 1557797206, 32 clinicians

Practice addresses (Care Compare)

1747 Imperial Blvd
Lake Charles, LA 70605-5362
Phone (337) 721-7236

Hospital & facility affiliations

  • Christus Ochsner St Patrick Hospital Hospital, Lake Charles, LA, CCN 190027
  • Lake Charles Memorial Hospital Hospital, Lake Charles, LA, CCN 190060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN84018LAMDOrthopedic Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopaedics and Spine LLC CurrentSince Aug 12, 2021 Accepting new patients
Center for Orthopaedics and Spine LLC CurrentSince Aug 12, 2021 Accepting new patients

Locations

1355 Sam Houston Jones Pkwy
Ste 340
Lake Charles, LA 70611
Phone (337) 721-7236

501 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 312-8258

1747 Imperial Blvd
Lake Charles, LA 70605
Phone (337) 721-7236

Interoperability endpoints

  • Direct secure messaging: tvanwinkle@direct.centerforortho.com

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1922018167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1747 IMPERIAL BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1747 IMPERIAL BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055362",
            "telephone_number": "337-721-7236",
            "fax_number": "337-721-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANWINKLE",
        "first_name": "TIMOTHY",
        "middle_name": "ERIC",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0800X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Orthopedic",
            "state": "LA",
            "license": "RN84018",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "221156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "221156",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "RN84018",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIMOTHY",
            "last_name": "VAN WINKLE",
            "middle_name": "ERIC",
            "prefix": "MR.",
            "credential": "NP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.