Individual provider Active NPI

Chienyenwa N Nwachuku-Winful, MBBS

  • Family Medicine Physician
  • Fridley, MN
National Provider Identifier
1952376675
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
46064 Issued in MN
Practice address
500 Osborne Rd NE Ste 255
Fridley, MN 55432-2768
Phone
(763) 236-2500
NPI assigned
Feb 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 46064 MN Primary

Addresses

Primary practice location

500 Osborne Rd NE Ste 255
Fridley, MN 55432-2768

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-5000

Other practice location 1

4155 County Road 101 N
Plymouth, MN 55446-2307
Phone (952) 993-8900

Other identifiers 1

IdentifierTypeStateIssuer
862929300MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040224000385 MN Practitioner - Family Practice 0547156978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Park Nicollet ClinicGroup PAC ID 7911819438, 1,778 clinicians

Practice addresses (Care Compare)

3850 Park Nicollet Blvd
St Louis Park, MN 55416-2527
Phone (952) 993-3123

Hospital & facility affiliations

  • Park Nicollet Methodist Hospital Hospital, Saint Louis Park, MN, CCN 240053

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
46064MNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Nicollet Clinic Family Medicine Current Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Dec 14, 2015 Accepting new patients
Park Nicollet Clinic Family Medicine CurrentSince Dec 14, 2015 Accepting new patients

Locations

6000 Earle Brown Dr
Minneapolis, MN 55430
Phone (952) 993-4800

5320 Hyland Greens Dr
Minneapolis, MN 55437
Phone (952) 993-2400

4155 County Road 101 N
Plymouth, MN 55446
Phone (952) 977-3000

3850 Park Nicollet Blvd
St Louis Park, MN 55416
Phone (952) 883-1000

Organizations & group practices 3

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 6

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": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1952376675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 OSBORNE RD NE STE 255",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554322768",
            "telephone_number": "763-236-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4155 County Road 101 N",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MN",
            "postal_code": "554462307",
            "country_code": "US",
            "telephone_number": "952-993-8900",
            "fax_number": "952-993-8955",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NWACHUKU-WINFUL",
        "first_name": "CHIENYENWA",
        "middle_name": "N",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-17",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "46064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "862929300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fridley, MN

Sources for this page

Verify at the official NPI Registry.