Individual provider Active NPI

Renee Marie Worrell, MSN, CNM

  • Midwife
  • Trenton, MI
National Provider Identifier
1053593020
Registry record updated Jul 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
4704193908 Issued in MI
Practice address
2275 W Jefferson Ave
Trenton, MI 48183-2114
Phone
(734) 675-7210
Fax
(734) 675-3023
NPI assigned
Dec 3, 2007
Last updated
Jul 14, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 4704193908 MI Primary

Addresses

Primary practice location

2275 W Jefferson Ave
Trenton, MI 48183-2114

Mailing address

2275 W Jefferson Ave
Trenton, MI 48183-2114
Phone (734) 675-7210

Other names 1

  • Renee Marie Sisk Former name

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, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
4704193908MIMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Ashwin H Shah MD PC Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://app.meldrx.com/api/fhir/uc35511_ashwinshahmd

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": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279065600000",
    "number": "1053593020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2275 W JEFFERSON AVE",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832114",
            "telephone_number": "734-675-7210",
            "fax_number": "734-675-3023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2275 W JEFFERSON AVE",
            "city": "TRENTON",
            "state": "MI",
            "postal_code": "481832114",
            "telephone_number": "734-675-7210",
            "fax_number": "734-675-3023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORRELL",
        "first_name": "RENEE",
        "middle_name": "MARIE",
        "credential": "MSN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2010-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "MI",
            "license": "4704193908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RENEE",
            "last_name": "SISK",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Trenton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2010; 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.