Thirteenth Moon Midwifery

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

RN118053 Issued in CO

Legal business name

THIRTEENTH MOON MIDWIFERY

Practice address

2614 W Vine Dr
Fort Collins, CO 80521-1504

Phone

(970) 227-3555

Fax

(970) 822-0455

NPI assigned

Jul 16, 2011

Organization subpart

No

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

Authorized official

Name

Carol RoedockerNPI 1508160169

Title

CNM/Owner

Phone

(970) 227-3555

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• 13th Moon Midwifery Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carol Hardin Roedocker, CNM

  • Advanced Practice Midwife
  • Fort Collins, CO
  • NPI 1508160169
  Medicare reassignment NPD Authorized official
• Deborah E Lieberman, PA-C

  • Physician Assistant
  • Fort Collins, CO
  • NPI 1639533540
  Medicare reassignment NPD

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

{
    "created_epoch": "1310774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732406400000",
    "number": "1295023893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2614 W VINE DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805211504",
            "telephone_number": "970-227-3555",
            "fax_number": "970-822-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2614 W VINE DR",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805211504",
            "telephone_number": "970-227-3555",
            "fax_number": "970-822-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIRTEENTH MOON MIDWIFERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-16",
        "last_updated": "2024-11-24",
        "certification_date": "2024-11-24",
        "status": "A",
        "authorized_official_last_name": "ROEDOCKER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_title_or_position": "CNM/OWNER",
        "authorized_official_telephone_number": "970-227-3555"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CO",
            "license": "RN118053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10788263",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "13th Moon Midwifery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelly Leigh Thielk, LCSW, ADS
• William J Thieman, M.D.
• Kristy Renee Thiemann, OTR/L
• Sydney Thien
• Brandon Thill, DPT
• Sarina Thoendel
• Thole Inc.
• Cali Thole, LMFT, LAC, MS
• Justin W Thole, D.C.
• Kirsten Jane Thom, LCSW, LAC, MSW

• Health Service Clinic/Center in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Health Service Clinic/Center in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.