Individual provider Active NPI

Barbara S Peckham-Devine, C.N.M.

  • Advanced Practice Midwife
  • Phoenix, AZ
National Provider Identifier
1265412159
Registry record updated Feb 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
Practice address
500 W Thomas Rd Ste 720&730
Phoenix, AZ 85013-4224
Phone
(602) 406-3715
NPI assigned
Jan 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2020

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 120003 NE
Advanced Practice Midwife 367A00000X PA Primary

Addresses

Primary practice location

500 W Thomas Rd Ste 720&730
Phoenix, AZ 85013-4224

Mailing address

575 Coal Valley Rd Ste 209
Clairton, PA 15025-3724
Phone (412) 267-6600

Other practice location 1

2115 N Kansas Ave
Suite 204
Hastings, NE 68901-2644
Phone (402) 463-6793

Other practice location 2

575 Coal Valley Rd Ste 209
Clairton, PA 15025-3724
Phone (412) 267-6600

Other practice location 3

217 E Stolley Park Rd
Grand Island, NE 68801-8201
Phone (308) 384-7625

Other identifiers 1

IdentifierTypeStateIssuer
103470380MedicaidPA

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581465600000",
    "number": "1265412159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 COAL VALLEY RD STE 209",
            "city": "CLAIRTON",
            "state": "PA",
            "postal_code": "150253724",
            "telephone_number": "412-267-6600",
            "fax_number": "412-267-6281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W THOMAS RD STE 720&730",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850134224",
            "telephone_number": "602-406-3715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2115 N Kansas Ave",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Hastings",
            "state": "NE",
            "postal_code": "689012644",
            "country_code": "US",
            "telephone_number": "402-463-6793",
            "fax_number": "402-463-6894",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "575 Coal Valley Rd Ste 209",
            "address_purpose": "LOCATION",
            "city": "Clairton",
            "state": "PA",
            "postal_code": "150253724",
            "country_code": "US",
            "telephone_number": "412-267-6600",
            "fax_number": "412-267-6281",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "217 E Stolley Park Rd",
            "address_purpose": "LOCATION",
            "city": "Grand Island",
            "state": "NE",
            "postal_code": "688018201",
            "country_code": "US",
            "telephone_number": "308-384-7625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PECKHAM-DEVINE",
        "first_name": "BARBARA",
        "middle_name": "S",
        "credential": "C.N.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2020-02-12",
        "certification_date": "2020-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NE",
            "license": "120003",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103470380",
            "state": "PA"
        }
    ],
    "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 Feb 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.