Active NPI
Mackenzie Rose Leeke, LM, CPM
- Midwife
- Nevada City, CA
National Provider Identifier
1114456340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- LM500
- Practice address
- 508 Redbud Way
Nevada City, CA 95959-2156 - Phone
- (530) 277-2043
- Fax
- (530) 572-1524
- NPI assigned
- Jun 10, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | LM500 | CA | Primary |
Addresses
Primary practice location
508 Redbud Way
Nevada City, CA 95959-2156
Mailing address
508 Redbud Way
Nevada City, CA 95959-2156
Phone (530) 277-2043
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114456340 | Other | CA | NPPES |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LM500 | CA | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mackenzie Rose Midwifery | Midwife | Current | 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.
-
- Midwife
- Nevada City, CA
- NPI 1104664002
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721088000000",
"number": "1114456340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 REDBUD WAY",
"city": "NEVADA CITY",
"state": "CA",
"postal_code": "959592156",
"telephone_number": "530-277-2043",
"fax_number": "530-572-1524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 REDBUD WAY",
"city": "NEVADA CITY",
"state": "CA",
"postal_code": "959592156",
"telephone_number": "530-277-2043",
"fax_number": "530-572-1524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEEKE",
"first_name": "MACKENZIE",
"middle_name": "ROSE",
"credential": "LM, CPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-10",
"last_updated": "2024-07-16",
"certification_date": "2024-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": "LM500",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPPES",
"identifier": "1114456340",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nevada City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 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.