Individual provider Active NPI

R. Renee Halstead, CNM NP RN

  • Midwife
  • Clovis, CA
National Provider Identifier
1336204163
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
NMW147
Practice address
722 Medical Center Dr E #101
Clovis, CA 93611
Phone
(559) 297-9500
Fax
(559) 297-9572
NPI assigned
Dec 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X NMW147 Primary

Addresses

Primary practice location

722 Medical Center Dr E #101
Clovis, CA 93611

Mailing address

722 Medical Center Dr E #101
Clovis, CA 93611
Phone (559) 297-9500

Other identifiers 1

IdentifierTypeStateIssuer
NMW001470MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150902002936 CA Practitioner - Certified Nurse Midwife (CNM) 3476869678 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Nurse Practitioner, Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foundation Medical Group CurrentSince Feb 1, 2018 Accepting new patients
Community Foundation Medical Group CurrentSince Feb 1, 2018 Accepting new patients
Community Foundation Medical Group Current Accepting new patients
University Faculty Associates, Inc. Past Accepting new patients

Locations

722 N Medical Center Dr E
Ste 101
Clovis, CA 93611
Phone (559) 297-9500

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

2625 E Divisadero St
Fresno, CA 93721
Phone (559) 453-5200

2823 Fresno St
Fresno, CA 93721
Phone (559) 459-3965

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1336204163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 MEDICAL CENTER DR E #101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "93611",
            "telephone_number": "559-297-9500",
            "fax_number": "559-297-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 MEDICAL CENTER DR E #101",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "93611",
            "telephone_number": "559-297-9500",
            "fax_number": "559-297-9572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALSTEAD",
        "first_name": "R.",
        "middle_name": "RENEE",
        "credential": "CNM NP RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-22",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": "NMW147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NMW001470",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.