Active NPI
Mary Dahl Maher, CNM
- Registered Nurse
- Brockport, NY
National Provider Identifier
1316973258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 276797-1
- Practice address
- 300 West Ave
Brockport, NY 14420-1118 - Phone
- (585) 637-3905
- Fax
- (585) 637-4990
- NPI assigned
- Jun 23, 2006
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 276797-1 | NY | Primary |
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | F360251-1 | NY | |
| Advanced Practice Midwife | 367A00000X | F000512-1 | NY |
Addresses
Primary practice location
300 West Ave
Brockport, NY 14420-1118
Mailing address
300 West Ave
Brockport, NY 14420-1118
Phone (585) 637-3905
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9512863 | Other | NY | INDEPENDENT HEALTH |
| 01543613 | Medicaid | NY | |
| 7737720 | Other | NY | AETNA HMO |
| 051028000007 | Other | NY | FIDELIS |
| MDJ073CQ | Other | NY | PREFERRED CARE |
| 000911495003 | Other | HEALTHNOW BCBSWNY BRCKPRT | |
| 000911495002 | Other | NY | HEALTHNOW BCBSWNY ALBION |
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
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 276797-1 | NY | MD | Registered Nurse |
| F360251-1 | NY | MD | Obstetrics & Gynecology Nurse Practitioner |
| F000512-1 | NY | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151020800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1316973258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 WEST AVE",
"city": "BROCKPORT",
"state": "NY",
"postal_code": "144201118",
"telephone_number": "585-637-3905",
"fax_number": "585-637-4990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 WEST AVE",
"city": "BROCKPORT",
"state": "NY",
"postal_code": "144201118",
"telephone_number": "585-637-3905",
"fax_number": "585-637-4990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHER",
"first_name": "MARY",
"middle_name": "DAHL",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-23",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "276797-1",
"primary": true
},
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "NY",
"license": "F360251-1",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "NY",
"license": "F000512-1",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDEPENDENT HEALTH",
"identifier": "9512863",
"state": "NY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01543613",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "7737720",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIDELIS",
"identifier": "051028000007",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PREFERRED CARE",
"identifier": "MDJ073CQ",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNOW BCBSWNY BRCKPRT",
"identifier": "000911495003",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNOW BCBSWNY ALBION",
"identifier": "000911495002",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Brockport, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.