Individual provider Active NPI

Carmen Cosby, CPM, LDM

  • Lay Midwife
  • Portland, OR
National Provider Identifier
1073876975
Registry record updated Jun 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lay MidwifeTaxonomy code 175M00000X
License
DEM-LD-10148190 Issued in OR
Practice address
3323 SW Naito Pkwy
Portland, OR 97239-4672
Phone
(503) 885-0228
Fax
(503) 274-0607
NPI assigned
Jun 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lay Midwife 175M00000X DEM-LD-10148190 OR Primary

Addresses

Primary practice location

3323 SW Naito Pkwy
Portland, OR 97239-4672

Mailing address

3323 SW Naito Pkwy
Portland, OR 97239-4672
Phone (503) 885-0228

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

LicenseStateTypeSpecialty
DEM-LD-10148190ORMDLay Midwife

NPI Registry JSON

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

{
    "created_epoch": "1339891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339891200000",
    "number": "1073876975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3323 SW NAITO PKWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394672",
            "telephone_number": "503-885-0228",
            "fax_number": "503-274-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3323 SW NAITO PKWY",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972394672",
            "telephone_number": "503-885-0228",
            "fax_number": "503-274-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COSBY",
        "first_name": "CARMEN",
        "credential": "CPM, LDM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-17",
        "last_updated": "2012-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175M00000X",
            "taxonomy_group": "",
            "desc": "Midwife, Lay",
            "state": "OR",
            "license": "DEM-LD-10148190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2012; 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.