Active NPI
Mary Beth Lodato, CERTIFIED NURSE MIDW
- Advanced Practice Midwife
- Evansville, IN
National Provider Identifier
1265431209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 72000026A
- Practice address
- 316 Chandler Ave
Evansville, IN 47713 - Phone
- (812) 436-4501
- Fax
- (812) 436-4510
- NPI assigned
- Jul 20, 2005
- 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 | 72000026A | IN | Primary |
Addresses
Primary practice location
316 Chandler Ave
Evansville, IN 47713
Mailing address
PO Box 3407
Evansville, IN 47733-3407
Phone (812) 450-3363
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000328977 | Other | ANTHEM BC/BS | |
| 200188920A | Medicaid | IN | |
| 11384964 | Other | CAQH PROVIDER ID | |
| 351791786109 | Other | IN | CARESOURCE PROVIDER ID |
| 200188920 | Medicaid | IN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72000026A | IN | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527638400000",
"number": "1265431209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3407",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477333407",
"telephone_number": "812-450-3363",
"fax_number": "812-450-3071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "316 CHANDLER AVE",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "47713",
"telephone_number": "812-436-4501",
"fax_number": "812-436-4510"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LODATO",
"first_name": "MARY",
"middle_name": "BETH",
"credential": "CERTIFIED NURSE MIDW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-20",
"last_updated": "2018-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "IN",
"license": "72000026A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "000000328977",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200188920A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH PROVIDER ID",
"identifier": "11384964",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARESOURCE PROVIDER ID",
"identifier": "351791786109",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200188920",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evansville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.