Individual provider Active NPI

Marianne C Stroud, CNM

  • Advanced Practice Midwife
  • Fort Wayne, IN
National Provider Identifier
1225442189
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
71006130A Issued in IN
Practice address
10228 Dupont Circle Dr E Ste 100
Fort Wayne, IN 46825-1611
Phone
(602) 227-4012
Fax
(260) 209-5956
NPI assigned
Jun 18, 2014
Last updated
Feb 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 28172191A IN
Advanced Practice Midwife 367A00000X 09000132A IN
Advanced Practice Midwife 367A00000X 71006130A IN Primary

Addresses

Primary practice location

10228 Dupont Circle Dr E Ste 100
Fort Wayne, IN 46825-1611

Mailing address

PO Box 772437
Detroit, MI 48277-2437
Phone (317) 575-7304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20170324002055 IN Practitioner - Certified Nurse Midwife (CNM) 5294010724 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
09000132AINMDAdvanced Practice Midwife
28172191AINMDAdvanced Practice Midwife
71006130AINMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Fertility and Midwifery Care Center LLC CurrentSince Mar 20, 2017 Accepting new patients
Cameron Memorial Community Hospital, Inc. CurrentSince Jan 27, 2024 Accepting new patients
Cameron Memorial Community Hospital, Inc CurrentSince Jan 27, 2024 Accepting new patients

Locations

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

306 E Maumee St
Ste 101
Angola, IN 46703
Phone (260) 432-8647

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

10228 DuPont Circle Dr E
Fort Wayne, IN 46825
Phone (219) 490-2525

10228 DuPont Circle Dr E
#100
Fort Wayne, IN 46825
Phone (260) 222-7401

2512 E DuPont Rd
Ste 105
Fort Wayne, IN 46825
Phone (260) 222-7401

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21210/brand/1/csg/1/fhir/r4
  • Direct secure messaging: marianne.stroud.2@21210.direct.athenahealth.com

Organizations & group practices 3

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": "1403049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1225442189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 772437",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482772437",
            "telephone_number": "317-575-7304",
            "fax_number": "317-575-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10228 DUPONT CIRCLE DR E STE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468251611",
            "telephone_number": "602-227-4012",
            "fax_number": "260-209-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROUD",
        "first_name": "MARIANNE",
        "middle_name": "C",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-18",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IN",
            "license": "28172191A",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IN",
            "license": "09000132A",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IN",
            "license": "71006130A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.