Kathleen M Mitcheom, LNM CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

000021 Issued in CT

Practice address

374 Grand Avenue
Fair Haven Community Health Ctr
New Haven, CT 06513

Phone

(203) 777-7411

Fax

(203) 777-8506

NPI assigned

Sep 11, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

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.

• Saint Raphael Faculty Physicians

  • Internal Medicine Physician
  • New Haven, CT
  • NPI 1932138138
  NPD (past)
• Saint Raphael Healthcare System Affiliated Physicians Inc

  • Neurology Physician
  • New Haven, CT
  • NPI 1063744001

  Advanced Practice Midwife

  NPD (past)

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

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285738336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 EAST HAYCOCK ROAD",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "06405",
            "telephone_number": "203-488-7035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 GRAND AVENUE",
            "address_2": "FAIR HAVEN COMMUNITY HEALTH CTR",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06513",
            "telephone_number": "203-777-7411",
            "fax_number": "203-777-8506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHEOM",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "LNM CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CT",
            "license": "000021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "0000219734",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "400000021CT01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "PSS4934",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Georgea Mitas, DPT
• Ellen Mitchell, RN
• Martha Minihan Mitchell, RNC MS CAPT NC USNR
• Mary Mitchell, APRN
• Michelle Mitchell, LCSW
• Alyssa Mitson-Salazar
• Matthew D Mitts
• Tiffany Moadel, M.D.
• Sharon Moales, LCSW
• Yasaman Moazeni

• Advanced Practice Midwife in New Haven, CT
• Providers in New Haven, CT by specialty
• Advanced Practice Midwife in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.