Individual provider Active NPI

Maura Maura Jansen, CPM, LDM

  • Midwife
  • Portland, OR
National Provider Identifier
1366935306
Registry record updated Jun 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
DEMLD10191443 Issued in OR
Practice address
7911 SE Stark St
Portland, OR 97215-2341
Phone
(503) 575-8596
Fax
(503) 334-4112
NPI assigned
Jun 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 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 DEMLD10191443 OR Primary

Addresses

Primary practice location

7911 SE Stark St
Portland, OR 97215-2341

Mailing address

2124 SE Oak St
Portland, OR 97214-1607
Phone (503) 575-8596

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
DEMLD10191443ORMDMidwife

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1366935306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 SE OAK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972141607",
            "telephone_number": "503-575-8596",
            "fax_number": "503-334-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7911 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972152341",
            "telephone_number": "503-575-8596",
            "fax_number": "503-334-4112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "MAURA",
        "middle_name": "MAURA",
        "credential": "CPM, LDM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "OR",
            "license": "DEMLD10191443",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.