Individual provider Active NPI

Janette Joy Gyesky, LDM, CPM

  • Midwife
  • Bend, OR
National Provider Identifier
1104980929
Registry record updated Dec 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
DEM-LD-10112513 Issued in OR
Practice address
375 NE Franklin Ave
Ste G.
Bend, OR 97701-4917
Phone
(541) 480-1401
Fax
(541) 749-2108
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X DEM-LD-10112513 OR Primary

Addresses

Primary practice location

375 NE Franklin Ave
Ste G.
Bend, OR 97701-4917

Mailing address

375 NE Franklin Ave
Ste G.
Bend, OR 97701-4917
Phone (541) 480-1401

Other identifiers 1

IdentifierTypeStateIssuer
006066MedicaidOR

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
DEM-LD-10112513ORMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Birth Center LLC 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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198195200000",
    "number": "1104980929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 NE FRANKLIN AVE",
            "address_2": "STE G.",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014917",
            "telephone_number": "541-480-1401",
            "fax_number": "541-749-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 NE FRANKLIN AVE",
            "address_2": "STE G.",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014917",
            "telephone_number": "541-480-1401",
            "fax_number": "541-749-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GYESKY",
        "first_name": "JANETTE",
        "middle_name": "JOY",
        "credential": "LDM, CPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "OR",
            "license": "DEM-LD-10112513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006066",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 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.