Individual provider Active NPI

Gayla Joy Wayman, CNM

  • Advanced Practice Midwife
  • Carbondale, IL
National Provider Identifier
1093820110
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
202 W Jackson St
Carbondale, IL 62901-1409
Phone
(618) 457-0465
Fax
(618) 457-8022
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

202 W Jackson St
Carbondale, IL 62901-1409

Mailing address

49 Candy LN
Murphysboro, IL 62966-2955
Phone (618) 457-0465

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
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
209001878ILMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Shawnee Health Service and Development Corp Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093820110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 CANDY LN",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629662955",
            "telephone_number": "618-457-0465",
            "fax_number": "618-457-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W JACKSON ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629011409",
            "telephone_number": "618-457-0465",
            "fax_number": "618-457-8022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAYMAN",
        "first_name": "GAYLA",
        "middle_name": "JOY",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.