Trillium Womancare LLC

Primary specialty

MidwifeTaxonomy code 176B00000X

License

CPM0000000030. Issued in TN

Legal business name

TRILLIUM WOMANCARE LLC

Practice address

2610 Autumn Avenue
Memphis, TN 38112

Phone

(901) 292-5354

Fax

(901) 452-8088

NPI assigned

Feb 6, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Amy Kristine Stewart-Banbury, CPM-TNNPI 1689714222

Title

Owner

Phone

(901) 292-5354

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amy Stewart-Banbury, CPN-TN

  • Midwife
  • Memphis, TN
  • NPI 1689714222
  NPD (past) Authorized official

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354233600000",
    "number": "1083754634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 AUTUMN AVENUE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38112",
            "telephone_number": "901-292-5354",
            "fax_number": "901-452-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2610 AUTUMN AVENUE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "38112",
            "telephone_number": "901-292-5354",
            "fax_number": "901-452-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRILLIUM WOMANCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2012-11-30",
        "status": "A",
        "authorized_official_last_name": "STEWART-BANBURY",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "KRISTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-292-5354",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPM-TN"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Midwife",
            "state": "TN",
            "license": "CPM0000000030.",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Advanced Practice Midwife",
            "state": "TN",
            "license": "APN 10920",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Midwife in Memphis, TN
• Providers in Memphis, TN by specialty
• Midwife in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.