Kelsey Lauren Ennis, CNM, WHNP-BC

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

0024180210 Issued in VA

Practice address

1417 2ND St Ste D
Santa Monica, CA 90401-2399

Phone

(646) 650-5337

Fax

(646) 871-6820

NPI assigned

Sep 14, 2020

Last updated

Mar 15, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, DC2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

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.

• Women's Health Services of Central Virginia, Inc.

  • Obstetrics & Gynecology Physician
  • Lynchburg, VA
  • NPI 1053417196
  Medicare reassignment NPD
• The Physician and Midwife Collaborative Practice

  • Obstetrics & Gynecology Physician
  • Lake Ridge, VA
  • NPI 1386829794
  Medicare reassignment
• The Physician and Midwife Collaborative Practice

  • Obstetrics Physician
  • Alexandria, VA
  • NPI 1831310820

  DC

  Medicare reassignment
• The Physician and Midwife Collaborative Practice

  • Obstetrics & Gynecology Physician
  • Alexandria, VA
  • NPI 1083899488
  NPD

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

{
    "created_epoch": "1600041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710460800000",
    "number": "1033724372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1417 2ND ST STE D",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012399",
            "telephone_number": "918-857-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1417 2ND ST STE D",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904012399",
            "telephone_number": "646-650-5337",
            "fax_number": "646-871-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "KELSEY",
        "middle_name": "LAUREN",
        "credential": "CNM, WHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-14",
        "last_updated": "2024-03-15",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "R0133249",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "VA",
            "license": "0024180210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charissa Endow, OTR/L
• Attara Enerva
• Jamie Soo Moi Eng, MD
• Cathy Annette Engel
• Vivian Engelsen
• Megan Ann Ennis, NP
• Enriched Hearts Home Care
• Maria J Enriquez, LCSW
• Rebeca Enriquez
• Cynthia Kay Epps, M.S. IBCLC

• Obstetrics & Gynecology Nurse Practitioner in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Obstetrics & Gynecology Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2024; 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.