Individual provider Active NPI

Michelle Elaine Brong, CNM

  • Advanced Practice Midwife
  • Portsmouth, NH
National Provider Identifier
1255931465
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
116396-23 Issued in NH
Practice address
67 Corporate Dr
Portsmouth, NH 03801-2847
Phone
(603) 610-8079
NPI assigned
Oct 27, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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 24320 SC
Advanced Practice Midwife 367A00000X 116396-23 NH Primary

Addresses

Primary practice location

67 Corporate Dr
Portsmouth, NH 03801-2847

Mailing address

PO Box 412503
Boston, MA 02241-2503
Phone (603) 610-8079

Other practice location 1

1300 Hospital Dr Ste 270
Mount Pleasant, SC 29464-3244
Phone (843) 818-1123

Other practice location 2

1 Wellness Blvd Ste 200
Irmo, SC 29063-2873
Phone (803) 567-2873

Other identifiers 2

IdentifierTypeStateIssuer
3153546MedicaidNH
MW0294MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220810002762 SC Practitioner - Certified Nurse Midwife (CNM) 2668855529
I20260205004428 NH Practitioner - Certified Nurse Midwife (CNM) 2668855529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

PO Box
Boston, MA 02241

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
116396-23NHMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Wentworth Douglass Physician Corporation CurrentSince Feb 16, 2026 Accepting new patients
Wentworth Douglass Physician Corporation CurrentSince Feb 16, 2026 Accepting new patients
Charleston Midwife Services Past Accepting new patients

Locations

789 Central Ave
Dover, NH 03820
Phone (603) 740-2832

67 Corporate Dr
Fl 2
Portsmouth, NH 03801
Phone (603) 610-8078

Organizations & group practices 4

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": "1603756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1255931465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022412503",
            "telephone_number": "603-610-8079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 CORPORATE DR",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038012847",
            "telephone_number": "603-610-8079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Hospital Dr Ste 270",
            "address_purpose": "LOCATION",
            "city": "Mount Pleasant",
            "state": "SC",
            "postal_code": "294643244",
            "country_code": "US",
            "telephone_number": "843-818-1123",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Wellness Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Irmo",
            "state": "SC",
            "postal_code": "290632873",
            "country_code": "US",
            "telephone_number": "803-567-2873",
            "fax_number": "803-437-8841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRONG",
        "first_name": "MICHELLE",
        "middle_name": "ELAINE",
        "name_prefix": "Miss",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-27",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "SC",
            "license": "24320",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NH",
            "license": "116396-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3153546",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MW0294",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.