Individual provider Active NPI

Ariella Shayanna Chung, CPM, LM

  • Advanced Practice Midwife
  • Mesa, AZ
National Provider Identifier
1205579398
Registry record updated Jun 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
CPM25030686 Issued in AZ
Practice address
2045 S Vineyard Ste 136
Mesa, AZ 85210-6891
Phone
(480) 565-5990
NPI assigned
Apr 15, 2022
Reactivated
Jun 10, 2025
Last updated
Jun 15, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X CPM25030686 AZ Primary
Doula 374J00000X AZ

Addresses

Primary practice location

2045 S Vineyard Ste 136
Mesa, AZ 85210-6891

Mailing address

650 S 97TH Way
Mesa, AZ 85208-2540
Phone (623) 272-8275

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

State licenses

LicenseStateTypeSpecialty
CPM25030686AZMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1649980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749945600000",
    "number": "1205579398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 S 97TH WAY",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852082540",
            "telephone_number": "623-272-8275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 S VINEYARD STE 136",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852106891",
            "telephone_number": "480-565-5990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUNG",
        "first_name": "ARIELLA",
        "middle_name": "SHAYANNA",
        "credential": "CPM, LM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-15",
        "last_updated": "2025-06-15",
        "certification_date": "2025-06-15",
        "deactivation_date": "2025-05-16",
        "reactivation_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "CPM25030686",
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "AZ",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.

Verify at the official NPI Registry.