Individual provider Active NPI

Kayce Danielle Pestrue, LM, CPM

  • Midwife
  • Cleburne, TX
National Provider Identifier
1336624360
Registry record updated Sep 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
99348 Issued in TX
Practice address
805 N Main St
Cleburne, TX 76033-3816
Phone
(817) 558-2229
Fax
(817) 641-2226
NPI assigned
Sep 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 99348 TX Primary

Addresses

Primary practice location

805 N Main St
Cleburne, TX 76033-3816

Mailing address

805 N Main St
Cleburne, TX 76033-3816
Phone (817) 558-2229

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

LicenseStateTypeSpecialty
99348TXMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537833600000",
    "number": "1336624360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N MAIN ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760333816",
            "telephone_number": "817-558-2229",
            "fax_number": "817-641-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N MAIN ST",
            "city": "CLEBURNE",
            "state": "TX",
            "postal_code": "760333816",
            "telephone_number": "817-558-2229",
            "fax_number": "817-641-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESTRUE",
        "first_name": "KAYCE",
        "middle_name": "DANIELLE",
        "name_prefix": "Ms.",
        "credential": "LM, CPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-25",
        "last_updated": "2018-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "TX",
            "license": "99348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleburne, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2018; 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.