Individual provider Active NPI

Vivian M Alvarez, CNM

  • Advanced Practice Midwife
  • Duluth, GA
National Provider Identifier
1124120167
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN105858 Issued in GA
Practice address
3650 Steve Reynolds Blvd
Department of Obstetrics & Gynecology
Duluth, GA 30096-4506
Phone
(770) 931-6012
NPI assigned
Sep 1, 2006
Last updated
Jan 6, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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 RN105858 GA Primary

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 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN105858GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Advanced Practice Midwife CurrentSince Apr 13, 2011 Accepting new patients
Northside Surgical Professional Services LLC CurrentSince 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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1124120167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3495 PIEDMONT RD NE",
            "address_2": "NINE PIEDMONT CENTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303051717",
            "telephone_number": "404-364-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 STEVE REYNOLDS BLVD",
            "address_2": "DEPARTMENT OF OBSTETRICS & GYNECOLOGY",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300964506",
            "telephone_number": "770-931-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALVAREZ",
        "first_name": "VIVIAN",
        "middle_name": "M",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-01",
        "last_updated": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN105858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodgam/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "3650 Steve Reynolds Blvd",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300964506",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Duluth, GA

Sources for this page

Verify at the official NPI Registry.