Active NPI
Colleen A. Mannering, CNM
- Advanced Practice Midwife
- Dedham, MA
National Provider Identifier
1053462721
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- Practice address
- 1 Lyons St
Dedham, MA 02026-5599 - Phone
- (781) 329-1400
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | Primary |
Addresses
Primary practice location
1 Lyons St
Dedham, MA 02026-5599
Mailing address
147 Milk St
Boston, MA 02109-4806
Phone (617) 559-8051
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0361071 | Medicaid | MA | |
| CN0187 | Other | MA | BCBS |
| 7006796-001 | Other | MA | CIGNA |
| F355 | Other | MA | HPHC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184630400000",
"number": "1053462721",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 MILK ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021094806",
"telephone_number": "617-559-8051",
"fax_number": "617-421-3487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 LYONS ST",
"city": "DEDHAM",
"state": "MA",
"postal_code": "020265599",
"telephone_number": "781-329-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNERING",
"first_name": "COLLEEN",
"middle_name": "A.",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0361071",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "CN0187",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "7006796-001",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPHC",
"identifier": "F355",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dedham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.