Individual provider Active NPI

Victoria Wirth

  • Advanced Practice Midwife
  • Warrensburg, NY
National Provider Identifier
1114934510
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
000572 Issued in NY
Practice address
3767 Main St
Warrensburg, NY 12885-1837
Phone
(518) 623-2844
Fax
(518) 623-3416
NPI assigned
Aug 1, 2006
Last updated
Jul 31, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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 000572 NY Primary

Addresses

Primary practice location

3767 Main St
Warrensburg, NY 12885-1837

Mailing address

1 Broad Street PLZ
PO Box 357
Glens Falls, NY 12801-4390
Phone (518) 761-0300

Other identifiers 1

IdentifierTypeStateIssuer
00630039MedicaidNY

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217462400000",
    "number": "1114934510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BROAD STREET PLZ",
            "address_2": "PO BOX 357",
            "city": "GLENS FALLS",
            "state": "NY",
            "postal_code": "128014390",
            "telephone_number": "518-761-0300",
            "fax_number": "518-745-1378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3767 MAIN ST",
            "city": "WARRENSBURG",
            "state": "NY",
            "postal_code": "128851837",
            "telephone_number": "518-623-2844",
            "fax_number": "518-623-3416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIRTH",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2008-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NY",
            "license": "000572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00630039",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrensburg, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.