Individual provider Active NPI

Vanessa Teal Landrum, CNM

  • Advanced Practice Midwife
  • Detroit, MI
National Provider Identifier
1346866480
Registry record updated Mar 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
4704314219 Issued in MI
Practice address
8575 Heritage PL
Detroit, MI 48204-2326
Phone
(313) 919-5965
NPI assigned
Jun 24, 2020
Last updated
Mar 11, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal Newborn Registered Nurse 163WM0102X 4704314219 MI
Advanced Practice Midwife 367A00000X
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1346866480 MI
Advanced Practice Midwife 367A00000X 4704314219 MI Primary

Addresses

Primary practice location

8575 Heritage PL
Detroit, MI 48204-2326

Mailing address

8575 Heritage PL
Detroit, MI 48204-2326
Phone (313) 919-5965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: No
  • 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
I20211213001679 MI Practitioner - Certified Nurse Midwife (CNM) 3274923966 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1346866480MIMDPsychiatric/Mental Health Nurse Practitioner
4704314219MIMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Birth Detroit Inc. CurrentSince Apr 13, 2025 Accepting new patients
Birth Detroit Care CurrentSince Apr 13, 2025 Accepting new patients

Locations

8575 Heritage Pl
Detroit, MI 48204
Phone (313) 919-5965

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773187200000",
    "number": "1346866480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8575 HERITAGE PL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482042326",
            "telephone_number": "313-919-5965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8575 HERITAGE PL",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482042326",
            "telephone_number": "313-919-5965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRUM",
        "first_name": "VANESSA",
        "middle_name": "TEAL",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2026-03-11",
        "certification_date": "2026-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0102X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "MI",
            "license": "4704314219",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "1346866480",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704314219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.