Individual provider Active NPI

Bethany Grace Adrian, LM, CPM

  • Midwife
  • Boerne, TX
National Provider Identifier
1104677343
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
99547 Issued in TX
Practice address
136 Old San Antonio Rd Ste 203
Boerne, TX 78006-3339
Phone
(210) 201-5530
NPI assigned
Mar 27, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 99547 TX Primary

Addresses

Primary practice location

136 Old San Antonio Rd Ste 203
Boerne, TX 78006-3339

Mailing address

136 Old San Antonio Rd Ste 203
Boerne, TX 78006-3339
Phone (210) 577-8041

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
99547TXMDMidwife

NPI Registry JSON

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1104677343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 OLD SAN ANTONIO RD STE 203",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063339",
            "telephone_number": "210-577-8041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 OLD SAN ANTONIO RD STE 203",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780063339",
            "telephone_number": "210-201-5530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADRIAN",
        "first_name": "BETHANY",
        "middle_name": "GRACE",
        "name_prefix": "Mrs.",
        "credential": "LM, CPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "TX",
            "license": "99547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.