Active NPI
Michelle Mamaril Davis, DNP, CNM
- Advanced Practice Midwife
- Phoenix, AZ
National Provider Identifier
1255842217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- AP10704
- Practice address
- 1300 N 12TH St Ste 620
Phoenix, AZ 85006-2850 - Phone
- (602) 283-3668
- NPI assigned
- Oct 18, 2017
- 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 | AP10704 | AZ | Primary |
Addresses
Primary practice location
1300 N 12TH St Ste 620
Phoenix, AZ 85006-2850
Mailing address
1300 N 12TH St Ste 620
Phoenix, AZ 85006-2850
Phone (602) 283-3668
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190613000708 | AZ | Practitioner - Certified Nurse Midwife (CNM) | 5597098145 |
Care Compare profile
Medicare Care Compare- Specialty
- Certified Nurse Midwife (CNM)
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- BHSM Rehabilitation LLC
Practice addresses (Care Compare)
2225 W Southern Ave
Suite a
Mesa, AZ 85202-4716
Phone (623) 888-3502
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP10704 | AZ | MD | Advanced Practice Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access for Her Foundation | Advanced Practice Midwife | Current | Accepting new patients |
| Banner - University Medical Center Phoenix | Past | Accepting new patients |
Locations
1300 N 12th St
Ste 620
Phoenix, AZ 85006
Phone (602) 283-3668
Interoperability endpoints
- michelle.davis.1@27328.direct.athenahealth.com
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.
-
- Advanced Practice Midwife
- Phoenix, AZ
- NPI 1346192812
-
- General Acute Care Hospital
- Phoenix, AZ
- NPI 1841224870
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508284800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712620800000",
"number": "1255842217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 N 12TH ST STE 620",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062850",
"telephone_number": "602-283-3668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 N 12TH ST STE 620",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850062850",
"telephone_number": "602-283-3668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "MICHELLE",
"middle_name": "MAMARIL",
"name_prefix": "Dr.",
"credential": "DNP, CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-10-18",
"last_updated": "2024-04-09",
"certification_date": "2024-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "AZ",
"license": "AP10704",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.