Kim Rae Guastella, CNM,ARNP

Primary specialty

MidwifeTaxonomy code 176B00000X

License

0024168019 Issued in VA

Practice address

19465 Deerfield Ave
Suite 205
Leesburg, VA 20176-1701

Phone

(703) 726-1300

Fax

(703) 726-9612

NPI assigned

Dec 10, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Wellstar Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Marietta, GA
  • NPI 1245539378
  NPD (past)

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380153600000",
    "number": "1013152784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 17334",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212971334",
            "telephone_number": "703-443-6717",
            "fax_number": "703-443-8643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19465 DEERFIELD AVE",
            "address_2": "SUITE 205",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201761701",
            "telephone_number": "703-726-1300",
            "fax_number": "703-726-9612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUASTELLA",
        "first_name": "KIM",
        "middle_name": "RAE",
        "credential": "CNM,ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-10",
        "last_updated": "2013-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "VA",
            "license": "0024168019",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "ARNP9319862",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013152784",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013152784",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaylie Nicole Brannan Groenhout
• Manisha Singh Grover, DDS
• David S. Groy, D.D.S
• Adrianne J Gruner, FNP
• Doreen Faye Grzelak, NP-C
• Madona Guirgis
• Marina Olivia Guirguis Hanna, M.D.
• Emily Tanski Gunnells, PA-C
• Charu Gupta, PA-C
• Sunil Gupta, MD

• Midwife in Leesburg, VA
• Providers in Leesburg, VA by specialty
• Midwife in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; 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.