Active NPI
Coeli Dwivedi, LDM, CPM
- Midwife
- Ashland, OR
National Provider Identifier
1053520288
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- DEM-LD-1002847
- Practice address
- 800 Cambridge St
Ashland, OR 97520-1008 - Phone
- (541) 488-8324
- Fax
- (541) 488-8324
- NPI assigned
- May 22, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Midwife | 176B00000X | DEM-LD-1002847 | OR | Primary |
Addresses
Primary practice location
800 Cambridge St
Ashland, OR 97520-1008
Mailing address
800 Cambridge St
Ashland, OR 97520-1008
Phone (541) 488-8324
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 269634 | Medicaid | OR |
Other names 1
- Gwen Johnson
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEM-LD-1002847 | OR | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205452800000",
"number": "1053520288",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 CAMBRIDGE ST",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975201008",
"telephone_number": "541-488-8324",
"fax_number": "541-488-8324"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 CAMBRIDGE ST",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975201008",
"telephone_number": "541-488-8324",
"fax_number": "541-488-8324"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DWIVEDI",
"first_name": "COELI",
"credential": "LDM, CPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-22",
"last_updated": "2008-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "OR",
"license": "DEM-LD-1002847",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "269634",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "GWEN",
"last_name": "JOHNSON",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Ashland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.