Individual provider Active NPI

Andrea Raine, CPM, LM

  • Midwife
  • Stevens Point, WI
National Provider Identifier
1003003773
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
30-049 Issued in WI
Practice address
2108 Church St
Stevens Point, WI 54481-4503
Phone
(715) 345-1222
NPI assigned
Sep 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lay Midwife 175M00000X 30-049 WI
Midwife 176B00000X 30-049 WI Primary

Addresses

Primary practice location

2108 Church St
Stevens Point, WI 54481-4503

Mailing address

2108 Church St
Stevens Point, WI 54481-4503
Phone (715) 345-1222

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

LicenseStateTypeSpecialty
30-049WIMDMidwife

NPI Registry JSON

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1003003773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 CHURCH ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544814503",
            "telephone_number": "715-345-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 CHURCH ST",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544814503",
            "telephone_number": "715-345-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINE",
        "first_name": "ANDREA",
        "credential": "CPM, LM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175M00000X",
            "taxonomy_group": "",
            "desc": "Midwife, Lay",
            "state": "WI",
            "license": "30-049",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "WI",
            "license": "30-049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevens Point, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.