Active NPI
Nedra Hale, CPM RM
- Midwife
- Englewood, CO
National Provider Identifier
1063746394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- MWR114
- Practice address
- 3333 S Bannock St Ste 810
Englewood, CO 80110 - Phone
- (720) 454-5718
- Fax
- (720) 302-0055
- NPI assigned
- Sep 18, 2009
- Last updated
- Nov 6, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 0153 | AZ | |
| Midwife | 176B00000X | MWR114 | CO | Primary |
Addresses
Primary practice location
3333 S Bannock St Ste 810
Englewood, CO 80110
Mailing address
7175 S Penrose CT
Centennial, CO 80122
Phone (720) 454-5718
Other names 1
- Nedra Wilson
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 |
|---|---|---|---|
| 0153 | AZ | MD | Midwife |
| MWR114 | CO | MD | Midwife |
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.
-
- Midwife
- Monument, CO
- NPI 1326413113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572998400000",
"number": "1063746394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7175 S PENROSE CT",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "80122",
"telephone_number": "720-454-5718",
"fax_number": "888-972-9136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3333 S BANNOCK ST STE 810",
"city": "ENGLEWOOD",
"state": "CO",
"postal_code": "80110",
"telephone_number": "720-454-5718",
"fax_number": "720-302-0055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALE",
"first_name": "NEDRA",
"credential": "CPM RM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-18",
"last_updated": "2019-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "AZ",
"license": "0153",
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CO",
"license": "MWR114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "NEDRA",
"last_name": "WILSON",
"credential": "CPM RM LM",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Englewood, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.