Moonrise Midwifery and Women'S Health, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

1003461 Issued in AK

Legal business name

MOONRISE MIDWIFERY AND WOMEN'S HEALTH, LLC

Practice address

822 Basin Rd
Juneau, AK 99801-1037

Phone

(505) 681-7769

Fax

(877) 299-7953

NPI assigned

Aug 16, 2014

Organization subpart

No

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

Authorized official

Name

Meredith M Wallis, CNM, ANP

Title

Owner

Phone

(505) 681-7769

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1408147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1408147200000",
    "number": "1306245246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 BASIN RD",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998011037",
            "telephone_number": "505-681-7769",
            "fax_number": "877-299-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 BASIN RD",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998011037",
            "telephone_number": "505-681-7769",
            "fax_number": "877-299-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOONRISE MIDWIFERY AND WOMEN'S HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-16",
        "last_updated": "2014-08-16",
        "status": "A",
        "authorized_official_last_name": "WALLIS",
        "authorized_official_first_name": "MEREDITH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "505-681-7769",
        "authorized_official_credential": "CNM, ANP"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "AK",
            "license": "1003461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Juneau, AK
• Providers in Juneau, AK by specialty
• Health Service Clinic/Center in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2014; 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.