Individual provider Active NPI

Avery E Klepacki Allen, CNM

  • Advanced Practice Midwife
  • Springfield, MA
National Provider Identifier
1073019071
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
227039 Issued in AZ
Practice address
3300 Main St Ste 4D
Springfield, MA 01107-1112
Phone
(413) 794-8336
Fax
(413) 794-7345
NPI assigned
Mar 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201704570RN OR
Advanced Practice Midwife 367A00000X 227039 AZ Primary

Addresses

Primary practice location

3300 Main St Ste 4D
Springfield, MA 01107-1112

Mailing address

280 Chestnut St FL 2
Springfield, MA 01199-1001
Phone (413) 794-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220119001109 AZ Practitioner - Certified Nurse Midwife (CNM) 2365834686 Reassigns benefits to 1 organization
I20231101002027 MA Practitioner - Certified Nurse Midwife (CNM) 2365834686 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baystate Medical Practices IncGroup PAC ID 5991602971, 1,350 clinicians

Practice addresses (Care Compare)

3300 Main St
Springfield, MA 01107-1112
Phone (413) 794-7394

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201704570RNORMDRegistered Nurse
227039AZMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Baystate Medical Practices, Inc CurrentSince Oct 19, 2023 Accepting new patients
Center for True Harmony Wellness & Medicine PC CurrentSince Jan 1, 2022 Accepting new patients

Locations

2152 S Vineyard
Ste 138
Mesa, AZ 85210
Phone (480) 539-6646

3300 Main St
Ste 4D
Springfield, MA 01107
Phone (413) 794-8336

3300 Main St
Springfield, MA 01107
Phone (413) 794-7031

280 Chestnut St
Fl 2
Springfield, MA 01199
Phone (413) 788-4385

759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1073019071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST FL 2",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 MAIN ST STE 4D",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071112",
            "telephone_number": "413-794-8336",
            "fax_number": "413-794-7345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "AVERY",
        "middle_name": "E KLEPACKI",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-30",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201704570RN",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "227039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.