Active NPI
Mary Ross, CNM
- Midwife
- Anchorage, AK
National Provider Identifier
1124015649
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 191
- Practice address
- 4115 Lake Otis Pkwy
Anchorage, AK 99508-5213 - Phone
- (907) 563-7228
- Fax
- (907) 563-6278
- NPI assigned
- Sep 29, 2005
- Sex
- Female
- Sole proprietor
- No
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 | 191 | AK | Primary |
Addresses
Primary practice location
4115 Lake Otis Pkwy
Anchorage, AK 99508-5213
Mailing address
4115 Lake Otis Parkway
Anchorage, AK 99508
Phone (907) 563-7228
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM0191 | Medicaid | AK | |
| NP01741 | Medicaid | AK | |
| NP0174 | Medicaid | AK |
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)
- Enrolled
- Credentials
- Certified Nurse Midwife
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky | Past | Accepting new patients | |
| Alaska Women'S Health Services, Inc | Past | Accepting new patients |
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.
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- NPI 1083700686
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209600000000",
"number": "1124015649",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4115 LAKE OTIS PARKWAY",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "99508",
"telephone_number": "907-563-7228",
"fax_number": "907-563-6278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4115 LAKE OTIS PKWY",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995085213",
"telephone_number": "907-563-7228",
"fax_number": "907-563-6278"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROSS",
"first_name": "MARY",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-09-29",
"last_updated": "2008-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "AK",
"license": "191",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NM0191",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP01741",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NP0174",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.