Vivian M Alvarez, CNM

Individual provider Active NPI Advanced Practice Midwife · Duluth, GA

NPI 1124120167 · NPPES record last updated Jan 6, 2022

Key facts

NPI
1124120167
Entity type
Individual (NPI type 1)
Primary specialty
Advanced Practice Midwife 367A00000X
License
RN105858 (GA)
Practice address
3650 Steve Reynolds Blvd
Department of Obstetrics & Gynecology
Duluth, GA 30096-4506
Phone
(770) 931-6012
NPI assigned
Sep 1, 2006
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20041210000275 GA Practitioner - Certified Nurse Midwife (CNM) 6406813542 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Advanced Practice Midwife Current
since Apr 13, 2011
Accepting new patients
Northside Surgical Professional Services LLC Current
since Dec 1, 2023
Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

1800 Northside Forsyth Dr
Ste 350
Cumming, GA 30041
Phone (770) 205-6501

3650 Steve Reynolds Blvd
Duluth, GA 30096
Phone (770) 931-6010

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN105858 GA Yes

Addresses

Primary practice location

3650 Steve Reynolds Blvd
Department of Obstetrics & Gynecology
Duluth, GA 30096-4506

Mailing address

3495 Piedmont Rd NE
Nine Piedmont Center
Atlanta, GA 30305-1717
Phone (404) 364-7000

Electronic endpoints

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq Health Information Exchange (HIE) Permanente Medical Group

Other providers in Duluth, GA

All providers in Duluth, GA · Advanced Practice Midwife in Georgia

Sources for this page

Verify at the official NPI Registry.