Active NPI
Ellyn Wyman-Grothem, CBW
- Doula
- Saint Paul, MN
National Provider Identifier
1184414260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Doula
- Practice address
- 1619 Dayton Ave Ste 316
Saint Paul, MN 55104-6276 - Phone
- (952) 250-0317
- NPI assigned
- May 12, 2025
- 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 |
|---|---|---|---|---|
| Doula | 374J00000X | Primary |
Addresses
Primary practice location
1619 Dayton Ave Ste 316
Saint Paul, MN 55104-6276
Mailing address
455 View St
Saint Paul, MN 55102-3427
Phone (952) 250-0317
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747008000000",
"number": "1184414260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "455 VIEW ST",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551023427",
"telephone_number": "952-250-0317"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1619 DAYTON AVE STE 316",
"city": "SAINT PAUL",
"state": "MN",
"postal_code": "551046276",
"telephone_number": "952-250-0317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYMAN-GROTHEM",
"first_name": "ELLYN",
"credential": "CBW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-12",
"last_updated": "2025-05-12",
"certification_date": "2025-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Paul, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.