Individual provider Active NPI

Danika Severino Wynn, CNM

  • Advanced Practice Midwife
  • Brooklyn, NY
National Provider Identifier
1063829950
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
CNM00148 Issued in RI
Practice address
171 Gates Ave # 1
Brooklyn, NY 11238-1903
Phone
(401) 447-9773
NPI assigned
Jul 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X CNM00148 RI Primary

Addresses

Primary practice location

171 Gates Ave # 1
Brooklyn, NY 11238-1903

Mailing address

171 Gates Ave # 1
Brooklyn, NY 11238-1903
Phone (401) 447-9773

Other practice location 1

175 Broad St
Providence, RI 02903-4026
Phone (401) 421-9620

Other practice location 2

345 Whitney Ave
New Haven, CT 06511-2348
Phone (513) 587-5095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20150204002194 RI Practitioner - Certified Nurse Midwife (CNM) 1850616301 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Services Landmark LLC CurrentSince Nov 1, 2014 Accepting new patients
Prime Healthcare Services Landmark LLC Advanced Practice Midwife CurrentSince Nov 1, 2014 Accepting new patients

Locations

206 Cass Ave
Woonsocket, RI 02895
Phone (401) 597-5070

Organizations & group practices 3

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": "1405209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1063829950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 GATES AVE # 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112381903",
            "telephone_number": "401-447-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 GATES AVE # 1",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112381903",
            "telephone_number": "401-447-9773"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 Broad St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034026",
            "country_code": "US",
            "telephone_number": "401-421-9620",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "345 Whitney Ave",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065112348",
            "country_code": "US",
            "telephone_number": "513-587-5095",
            "fax_number": "513-587-5095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEVERINO WYNN",
        "first_name": "DANIKA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-13",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "RI",
            "license": "CNM00148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.