Active NPI
Reina Marie Dastous, CNM
- Advanced Practice Midwife
- Beverly, MA
National Provider Identifier
1124222880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 245530
- Practice address
- 85 Herrick St
Beverly, MA 01915-1790 - Phone
- (978) 927-7880
- Fax
- (978) 524-6082
- NPI assigned
- Jun 14, 2007
- 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 |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 245530 | MA | Primary |
Addresses
Primary practice location
85 Herrick St
Beverly, MA 01915-1790
Mailing address
Lahey Clinic Inc., Provider Enrollment Department
41 Mall Road
Burlington, MA 01805
Phone (781) 744-8085
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 245530 | MA | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1517443200000",
"number": "1124222880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "LAHEY CLINIC INC., PROVIDER ENROLLMENT DEPARTMENT",
"address_2": "41 MALL ROAD",
"city": "BURLINGTON",
"state": "MA",
"postal_code": "01805",
"telephone_number": "781-744-8085",
"fax_number": "781-744-5433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85 HERRICK ST",
"city": "BEVERLY",
"state": "MA",
"postal_code": "019151790",
"telephone_number": "978-927-7880",
"fax_number": "978-524-6082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DASTOUS",
"first_name": "REINA",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-14",
"last_updated": "2018-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "MA",
"license": "245530",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beverly, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.