Individual provider Active NPI

Niamh Aibhlinn Charles, CNM

  • Advanced Practice Midwife
  • Salem, OR
National Provider Identifier
1093960221
Registry record updated Jul 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
200850501NP Issued in OR
Practice address
13160 Jerusalem Hill Rd. NW
Salem, OR 97304
Phone
(503) 315-2229
Fax
(503) 868-7286
NPI assigned
Dec 2, 2008
Last updated
Jul 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2015

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 200850501NP OR Primary

Addresses

Primary practice location

13160 Jerusalem Hill Rd. NW
Salem, OR 97304

Mailing address

13160 Jerusalem Hill Rd. NW
Salem, OR 97304
Phone (503) 315-2229

Other identifiers 3

IdentifierTypeStateIssuer
213342MedicaidOR
1619915113OtherORWATERFALL CLINIC, INC. GROUP NPI
500638900MedicaidOR

Other names 1

  • Lenore Adeille Charles Former name

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)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
200850501NPORMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1228176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1093960221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13160 JERUSALEM HILL RD. NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97304",
            "telephone_number": "503-315-2229",
            "fax_number": "503-868-7286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13160 JERUSALEM HILL RD. NW",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97304",
            "telephone_number": "503-315-2229",
            "fax_number": "503-868-7286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "NIAMH",
        "middle_name": "AIBHLINN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-02",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "200850501NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "213342",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WATERFALL CLINIC, INC. GROUP NPI",
            "identifier": "1619915113",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500638900",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LENORE",
            "last_name": "CHARLES",
            "middle_name": "ADEILLE",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; 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.