Individual provider Active NPI

Taylor Elizabeth Mertz, CNM

  • Advanced Practice Midwife
  • Fargo, ND
National Provider Identifier
1366810962
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
R47334 Issued in ND
Practice address
3000 32ND Ave S
Fargo, ND 58103
Phone
(701) 364-8000
Fax
(701) 364-8078
NPI assigned
Sep 14, 2015
Last updated
Jul 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X R47334 ND Primary

Addresses

Primary practice location

3000 32ND Ave S
Fargo, ND 58103

Mailing address

400 E 3Rd St
Duluth, MN 55805-1951

Other practice location 1

624 Smith Ave S
Saint Paul, MN 55107-2620
Phone (612) 689-3988

Other practice location 2

3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-8000

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)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
R47334NDMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1366810962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 32ND AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-364-8000",
            "fax_number": "701-364-8078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 Smith Ave S",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551072620",
            "country_code": "US",
            "telephone_number": "612-689-3988",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000 32nd Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "58103",
            "country_code": "US",
            "telephone_number": "701-364-8000",
            "fax_number": "701-364-8078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MERTZ",
        "first_name": "TAYLOR",
        "middle_name": "ELIZABETH",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-14",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "ND",
            "license": "R47334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.