Individual provider Active NPI

Tanya Elan Bullwinkle, L.M.

  • Midwife
  • Eureka, CA
National Provider Identifier
1003053968
Registry record updated Dec 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
LM238 Issued in CA
Practice address
3225 Timber Fall CT
Eureka, CA 95503-4892
Phone
(707) 442-5700
NPI assigned
Jan 14, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X LM238 CA Primary

Addresses

Primary practice location

3225 Timber Fall CT
Eureka, CA 95503-4892

Mailing address

475 Howard Heights Rd
Eureka, CA 95503-9570
Phone (707) 407-7566

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
LM238CAMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Six Rivers Planned Parenthood Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tanya.bullwinklelm.p1@direct.ppnorcal.nextgenshare.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1231891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355875200000",
    "number": "1003053968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 HOWARD HEIGHTS RD",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955039570",
            "telephone_number": "707-407-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 TIMBER FALL CT",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034892",
            "telephone_number": "707-442-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLWINKLE",
        "first_name": "TANYA",
        "middle_name": "ELAN",
        "credential": "L.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-14",
        "last_updated": "2012-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "LM238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2012; 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.