Individual provider Active NPI

Kristin Wiley, CNM

  • Advanced Practice Midwife
  • Cheshire, CT
National Provider Identifier
1023340437
Registry record updated May 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
341 Issued in CT
Practice address
675 S Main St
Cheshire, CT 06410-3153
Phone
(203) 272-1811
NPI assigned
Feb 10, 2010
Last updated
May 27, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X CMW00130 RI
Advanced Practice Midwife 367A00000X 341 CT Primary

Addresses

Primary practice location

675 S Main St
Cheshire, CT 06410-3153

Mailing address

675 S Main St
Cheshire, CT 06410-3153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20160706000100 CT Practitioner - Certified Nurse Midwife (CNM) 1355479056 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Yale University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Planned Parenthood of Southern New England IncGroup PAC ID 3173436730, 41 clinicians

Practice addresses (Care Compare)

345 Whitney Ave
New Haven, CT 06511-2348
Phone (203) 503-0450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
000341CTMDMarriage & Family Therapist
CMW00130RIMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Southern New England, Inc. CurrentSince Sep 1, 2020 Accepting new patients

Locations

345 Whitney Ave
New Haven, CT 06511
Phone (203) 503-0450

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1265760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464307200000",
    "number": "1023340437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 S MAIN ST",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103153",
            "telephone_number": "203-272-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "KRISTIN",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-10",
        "last_updated": "2016-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "RI",
            "license": "CMW00130",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CT",
            "license": "341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

Verify at the official NPI Registry.