Individual provider Active NPI

Kirsten Eckert, CNM

  • Advanced Practice Midwife
  • Santa Rosa, CA
National Provider Identifier
1306246772
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
235674 Issued in CA
Practice address
500 Doyle Park Dr Suite 103
Santa Rosa, CA 95405
Phone
(707) 579-1102
NPI assigned
Sep 3, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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 235674 CA Primary

Addresses

Primary practice location

500 Doyle Park Dr Suite 103
Santa Rosa, CA 95405

Mailing address

500 Doyle Park Dr Suite 103
Santa Rosa, CA 95405
Phone (707) 579-1102

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)
Enrolled
Credentials
Certified Nurse Midwife

NPI Registry JSON

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1306246772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR SUITE 103",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-579-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 DOYLE PARK DR SUITE 103",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-579-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECKERT",
        "first_name": "KIRSTEN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "235674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.