Organization Active NPI

Modern Mama

  • Midwife
  • Medford, MA
National Provider Identifier
1013426204
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
Legal business name
MODERN MAMA
Practice address
21 Aquavia Rd
Medford, MA 02155-1002
Phone
(860) 919-5563
Fax
(617) 765-7318
NPI assigned
Sep 20, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mrs. Kara Lynne Schamell, CPMNPI 1023691078
Title
Co-Manager
Phone
(860) 919-5563

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X NU Primary
Doula 374J00000X NU

Addresses

Primary practice location

21 Aquavia Rd
Medford, MA 02155-1002

Mailing address

21 Aquavia Rd
Medford, MA 02155-1002
Phone (860) 919-5563

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1013426204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 AQUAVIA RD",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551002",
            "telephone_number": "860-919-5563",
            "fax_number": "617-765-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 AQUAVIA RD",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551002",
            "telephone_number": "860-919-5563",
            "fax_number": "617-765-7318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN MAMA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-20",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SCHAMELL",
        "authorized_official_first_name": "KARA",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "CO-MANAGER",
        "authorized_official_telephone_number": "860-919-5563",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPM"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.