Individual provider Active NPI

Tina A Winter, FNP

  • Family Nurse Practitioner
  • Maryville, IL
National Provider Identifier
1922676675
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
209023356 Issued in IL
Practice address
2090 Vadalabene Dr
Maryville, IL 62062-5841
Phone
(618) 288-5430
NPI assigned
Jun 17, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2021022247 MO
Family Nurse Practitioner 363LF0000X 209023356 IL Primary

Addresses

Primary practice location

2090 Vadalabene Dr
Maryville, IL 62062-5841

Mailing address

320 E Highway 50
O Fallon, IL 62269-2704
Phone (888) 577-6337

Other practice location 1

320 E Highway 50
O Fallon, IL 62269-2704
Phone (888) 577-6337

Other practice location 2

2001 State St
East Saint Louis, IL 62205-1803
Phone (618) 271-0204

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tina.winter.1@9559.direct.athenahealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20211115001037 IL Practitioner - Nurse Practitioner 0941699896 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Anderson Medical Group LLCGroup PAC ID 5193792018, 136 clinicians

Practice addresses (Care Compare)

2090 Vadalabene Dr
Maryville, IL 62062-5841
Phone (618) 288-5430

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
74.76 of 100Reported as group
Quality
54.98
Promoting interoperability
85
Improvement activities
40
Cost
73.39

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209023356ILMDFamily Nurse Practitioner
2021022247MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Healthcare Foundation Inc CurrentSince Nov 28, 2023 Accepting new patients
Midwest Inpatient Anderson Health, Inc CurrentSince Feb 1, 2022 Accepting new patients
Midwest Emergency Centralia Campus Associates, Inc CurrentSince Oct 15, 2021 Accepting new patients
Midwest Emergency Good Samaritan, Inc CurrentSince Oct 15, 2021 Accepting new patients
Southern Illinois Healthcare Foundation Inc Current Accepting new patients
Anderson Medical Group, LLC CurrentSince Dec 1, 2022 Accepting new patients
Southern Illinois Healthcare Foundation, Inc. CurrentSince Nov 28, 2023 Accepting new patients
Midwest Emergency Anderson Health, Inc CurrentSince Feb 1, 2022 Accepting new patients
Midwest Emergency Sparta, Inc CurrentSince Oct 15, 2021 Accepting new patients

Locations

159 E McArthur Dr
Bethalto, IL 62010
Phone (618) 258-7380

400 N Pleasant Ave
Centralia, IL 62801
Phone (618) 436-5221

1103 Belt Line Rd
Collinsville, IL 62234
Phone (618) 344-2273

5900 Bond Ave
East Saint Louis, IL 62207
Phone (618) 332-3060

2001 State St
East St Louis, IL 62205
Phone (618) 271-0204

3417 Anderson Healthcare Dr
Edwardsville, IL 62025
Phone (618) 288-4929

6800 State Route 162
Maryville, IL 62062
Phone (618) 288-4095

2090 Vadalabene Dr
Maryville, IL 62062
Phone (618) 288-5430

6810 State Route 162
Ste 215
Maryville, IL 62062
Phone (618) 391-6405

1 Good Samaritan Way
Mount Vernon, IL 62864
Phone (618) 242-4600

320 E Highway 50
O Fallon, IL 62269
Phone (618) 624-3368

2071 Goose Lake Rd
Sauget, IL 62206
Phone (314) 872-1473

2041 Goose Lake Rd
Sauget, IL 62206

818 E Broadway St
Sparta, IL 62286
Phone (618) 443-2177

400 N Caldwell St
Staunton, IL 62088
Phone (618) 635-2200

108 W US Highway 40
Troy, IL 62294
Phone (618) 391-5065

Interoperability endpoints

  • Direct secure messaging: tina.winter.1@9559.direct.athenahealth.com

Organizations & group practices 9

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 3

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": "1623888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1922676675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 E HIGHWAY 50",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692704",
            "telephone_number": "888-577-6337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 VADALABENE DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625841",
            "telephone_number": "618-288-5430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "320 E Highway 50",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622692704",
            "country_code": "US",
            "telephone_number": "888-577-6337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2001 State St",
            "address_purpose": "LOCATION",
            "city": "East Saint Louis",
            "state": "IL",
            "postal_code": "622051803",
            "country_code": "US",
            "telephone_number": "618-271-0204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINTER",
        "first_name": "TINA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-17",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021022247",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209023356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tina.winter.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "2001 State St",
            "city": "East Saint Louis",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622051803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

Verify at the official NPI Registry.