Active NPI
Joyce M. Wilder, CNM, NP
- Advanced Practice Midwife
- Watertown, NY
National Provider Identifier
1255380580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- F000546
- Practice address
- 172 Clinton St
Watertown, NY 13601-3602 - Phone
- (315) 782-6262
- Fax
- (315) 782-5181
- NPI assigned
- May 5, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 420516 | NY | |
| Advanced Practice Midwife | 367A00000X | F000546 | NY | Primary |
Addresses
Primary practice location
172 Clinton St
Watertown, NY 13601-3602
Mailing address
1001 W Fayette St
Ste 400
Syracuse, NY 13204-2859
Phone (315) 472-1488
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, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 420516 | NY | MD | Women's Health Nurse Practitioner |
| F000546 | NY | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wise Woman OB/GYN, PC | Women's Health | Current | Accepting new patients |
| North Country Midwifery, PLLC | Women's Health | Past | Accepting new patients |
Locations
1001 W Fayette St
Ste 400
Syracuse, NY 13204
Phone (315) 472-1488
172 Clinton St
Watertown, NY 13601
Phone (315) 782-6262
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210723200000",
"number": "1255380580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 W FAYETTE ST",
"address_2": "STE 400",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132042859",
"telephone_number": "315-472-1488",
"fax_number": "315-476-1792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "172 CLINTON ST",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136013602",
"telephone_number": "315-782-6262",
"fax_number": "315-782-5181"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILDER",
"first_name": "JOYCE",
"middle_name": "M.",
"credential": "CNM, NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-05",
"last_updated": "2008-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "NY",
"license": "420516",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "NY",
"license": "F000546",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.