Active NPI
Lydia Mariah Douglas, CPM, LDM
- Midwife
- Grants Pass, OR
National Provider Identifier
1295350809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- DEM-LD-10208453
- Practice address
- 1453 Redwood Cir
Grants Pass, OR 97527-5523 - Phone
- (541) 916-8333
- NPI assigned
- Jun 9, 2020
- 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 |
|---|---|---|---|---|
| Midwife | 176B00000X | DEM-LD-10208453 | OR | Primary |
Addresses
Primary practice location
1453 Redwood Cir
Grants Pass, OR 97527-5523
Mailing address
1453 Redwood Cir
Grants Pass, OR 97527-5523
Phone (541) 916-8333
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20060005 | Other | NORTH AMERICAN REGISTRY OF MIDWIVES | |
| DEM-LD-10208453 | Other | OR | OREGON STATE MIDWIFERY LICENSE NUMBER |
Other names 1
- Lydia Mariah Martinez
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEM-LD-10208453 | OR | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lane County Midwives | Midwife | Current | Accepting new patients |
| Selah Midwifery | Midwife | Current | Accepting new patients |
Organizations & group practices 2
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.
-
- Midwife
- Eugene, OR
- NPI 1093690141
-
- Midwife
- Eugene, OR
- NPI 1023858040
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591660800000",
"number": "1295350809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1453 REDWOOD CIR",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275523",
"telephone_number": "541-916-8333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1453 REDWOOD CIR",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275523",
"telephone_number": "541-916-8333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGLAS",
"first_name": "LYDIA",
"middle_name": "MARIAH",
"credential": "CPM, LDM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-09",
"last_updated": "2020-06-09",
"certification_date": "2020-06-09",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "OR",
"license": "DEM-LD-10208453",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH AMERICAN REGISTRY OF MIDWIVES",
"identifier": "20060005",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OREGON STATE MIDWIFERY LICENSE NUMBER",
"identifier": "DEM-LD-10208453",
"state": "OR"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LYDIA",
"last_name": "MARTINEZ",
"middle_name": "MARIAH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.