Active NPI
Lori Ann Martin, CNM
- Midwife
- Goshen, IN
National Provider Identifier
1003499880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 09000372A
- Practice address
- 1929 W Lincoln Ave
Goshen, IN 46526-5909 - Phone
- (574) 849-4646
- NPI assigned
- Apr 30, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 09000372A | IN | Primary |
Addresses
Primary practice location
1929 W Lincoln Ave
Goshen, IN 46526-5909
Mailing address
64444A State Road 19
Goshen, IN 46526-9421
Phone (574) 849-4646
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09000372A | Other | IN | NURSE MIDWIFE LICENSE NUMBER |
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
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 09000372A | IN | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1619740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1619740800000",
"number": "1003499880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64444A STATE ROAD 19",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465269421",
"telephone_number": "574-849-4646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1929 W LINCOLN AVE",
"city": "GOSHEN",
"state": "IN",
"postal_code": "465265909",
"telephone_number": "574-849-4646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "LORI",
"middle_name": "ANN",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-30",
"last_updated": "2021-04-30",
"certification_date": "2021-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "IN",
"license": "09000372A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NURSE MIDWIFE LICENSE NUMBER",
"identifier": "09000372A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goshen, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.