Individual provider Active NPI

Michelle Mamaril Davis, DNP, CNM

  • Advanced Practice Midwife
  • Phoenix, AZ
National Provider Identifier
1255842217
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP10704 Issued in AZ
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

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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 LLCGroup PAC ID 2062773138, shared by 27 NPIs, 450 clinicians

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

LicenseStateTypeSpecialty
AP10704AZMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew 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

  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.