1396976189 NPI number — MRS. CASEY RYAN WINPIGLER O.D.

Table of content: MRS. CASEY RYAN WINPIGLER O.D. (NPI 1396976189)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396976189 NPI number — MRS. CASEY RYAN WINPIGLER O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WINPIGLER
Provider First Name:
CASEY
Provider Middle Name:
RYAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RYAN
Provider Other First Name:
CASEY
Provider Other Middle Name:
JOLYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1396976189
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/06/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1921 MEDICAL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARRISONBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22801-3437
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-433-2485
Provider Business Mailing Address Fax Number:
540-433-2010

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1921 MEDICAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISONBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22801-3437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-433-2485
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/28/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  OD705 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 0618002929 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 152W00000X , with the licence number: 7382TG , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)