Individual provider Active NPI

Elizabeth Cassidy, CPM, LM

  • Lay Midwife
  • Santa Fe, NM
National Provider Identifier
1356565139
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lay MidwifeTaxonomy code 175M00000X
License
96307-R Issued in NM
Practice address
1500 5TH St
Santa Fe, NM 87505-3480
Phone
(505) 470-1690
Fax
(505) 983-3003
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lay Midwife 175M00000X 96307-R NM Primary

Addresses

Primary practice location

1500 5TH St
Santa Fe, NM 87505-3480

Mailing address

2068 Calle Contento
Santa Fe, NM 87505-5406
Phone (505) 460-1690

Other identifiers 1

IdentifierTypeStateIssuer
48659517MedicaidNM

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
96307-RNMMDLay Midwife

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356565139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2068 CALLE CONTENTO",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875055406",
            "telephone_number": "505-460-1690",
            "fax_number": "505-983-3003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 5TH ST",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875053480",
            "telephone_number": "505-470-1690",
            "fax_number": "505-983-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "ELIZABETH",
        "credential": "CPM, LM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175M00000X",
            "taxonomy_group": "",
            "desc": "Midwife, Lay",
            "state": "NM",
            "license": "96307-R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "48659517",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Fe, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.