Individual provider Active NPI

Kerrie Lynn Decastro, CNM

  • Advanced Practice Midwife
  • Casa Grande, AZ
National Provider Identifier
1275358525
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
315170 Issued in AZ
Practice address
580 N Camino Mercado Ste 8
Casa Grande, AZ 85122-5757
Phone
(520) 836-3446
NPI assigned
Nov 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 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 315170 AZ Primary

Addresses

Primary practice location

580 N Camino Mercado Ste 8
Casa Grande, AZ 85122-5757

Mailing address

19509 E Walnut Rd
Queen Creek, AZ 85142-6229
Phone (623) 237-1534

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: No
  • 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
I20241213000055 AZ Practitioner - Certified Nurse Midwife (CNM) 2466988480 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
315170AZMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Sun Life Family Health Center, Inc. Current Accepting new patients
Sun Life Family Health Center, Inc. CurrentSince Dec 30, 2024 Accepting new patients
Sun Life Family Health Center, Inc. CurrentSince Dec 30, 2024 Accepting new patients
Sun Life Family Health Center, Inc. Current Accepting new patients
Sun Life Family Health Center, Inc. Past Accepting new patients
Sun Life Family Health Center, Inc. Past Accepting new patients

Locations

865 N Arizola Rd
Casa Grande, AZ 85122
Phone (520) 381-0363

1864 E Florence Blvd
Ste 2
Casa Grande, AZ 85122
Phone (520) 381-0320

1856 E Florence Blvd
Casa Grande, AZ 85122
Phone (520) 381-0380

580 N Camino Mercado
Ste 8
Casa Grande, AZ 85122
Phone (520) 381-0380

655 S Dobson Rd
Ste 201
Chandler, AZ 85224
Phone (480) 307-9471

1284 N Arizona Blvd
Coolidge, AZ 85128
Phone (520) 723-9131

205 N Stuart Blvd
Eloy, AZ 85131
Phone (520) 466-7883

174 W Highway 287
Florence, AZ 85132
Phone (520) 868-5811

10032 E Southern Ave
Mesa, AZ 85209
Phone (480) 339-2853

1040 W American Ave
Oracle, AZ 85623
Phone (520) 252-4707

23 S McNab Pkwy
San Manuel, AZ 85631
Phone (520) 385-2234

Organizations & group practices 6

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": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1275358525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19509 E WALNUT RD",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426229",
            "telephone_number": "623-237-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 N CAMINO MERCADO STE 8",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851225757",
            "telephone_number": "520-836-3446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECASTRO",
        "first_name": "KERRIE",
        "middle_name": "LYNN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "315170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Casa Grande, AZ

Sources for this page

Verify at the official NPI Registry.