Individual provider Active NPI

Bethany Nourse Golden, CNM

  • Advanced Practice Midwife
  • San Mateo, CA
National Provider Identifier
1104042712
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
1724 Issued in CA
Practice address
2211 Palm Ave
San Mateo, CA 94403-1814
Phone
(650) 574-2628
NPI assigned
Apr 18, 2007
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 1724 CA Primary

Addresses

Primary practice location

2211 Palm Ave
San Mateo, CA 94403-1814

Mailing address

1148 Church St
San Francisco, CA 94114-3433
Phone (646) 734-3625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190731002234 CA Practitioner - Certified Nurse Midwife (CNM) 8628304466 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care CurrentSince Feb 19, 2019 Accepting new patients
Lifelong Medical Care CurrentSince Feb 19, 2019 Accepting new patients

Locations

2344 6th St
Berkeley, CA 94710
Phone (510) 981-3203

10700 MacArthur Blvd
Ste 14B
Oakland, CA 94605
Phone (510) 563-4300

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104042712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1148 CHURCH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941143433",
            "telephone_number": "646-734-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 PALM AVE",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944031814",
            "telephone_number": "650-574-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDEN",
        "first_name": "BETHANY",
        "middle_name": "NOURSE",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

Verify at the official NPI Registry.