Kellie Gwaltney, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

235651 Issued in CA

Practice address

3400 Avenue of the Arts
Apt. #G317
Costa Mesa, CA 92626-1927

Phone

(307) 871-9333

NPI assigned

Dec 16, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kellie.gwaltney.p1@direct.dvmg.nextgenshare.com
• Direct secure messaging: kgwaltney1373586@oc.providencedirect.org

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.

• Obhg California, P.C.

  • Obstetrics & Gynecology Physician
  • Greenville, SC
  • NPI 1215258892

  CA

  Medicare reassignment NPD

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

{
    "created_epoch": "1418688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1013315563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 AVENUE OF THE ARTS",
            "address_2": "APT. #G317",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261927",
            "telephone_number": "307-871-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 AVENUE OF THE ARTS",
            "address_2": "APT. #G317",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926261927",
            "telephone_number": "307-871-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWALTNEY",
        "first_name": "KELLIE",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-16",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "235651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Georgina Guzman
• Giselle Guzman
• Guadalupe Guzman
• Larissa Guzman
• Perla Guzman
• Brian My Ha
• Cuong Gia Ha, MD
• Eric Younghoon Ha
• Jason T Ha
• Jordan Ha, AMFT

• Advanced Practice Midwife in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Advanced Practice Midwife in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.