Annette R Payot, CNM
Individual provider Active NPI Advanced Practice Midwife · Berwyn, IL
NPI 1376730366 · NPPES record last updated Dec 26, 2019
Key facts
- NPI
- 1376730366
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Advanced Practice Midwife 367A00000X
- License
- 209006749 (IL)
- Practice address
- 6201 Roosevelt Rd
Berwyn, IL 60402-1108 - Phone
- (708) 386-0845
- Fax
- (708) 386-8472
- NPI assigned
- Oct 3, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 17
Medicare Care Compare profile
- Specialty
- Certified Nurse Midwife (CNM)
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- PCC Community Wellness Center
Practice addresses (Care Compare)
14 Lake St
Oak Park, IL 60302-2606
Phone 7083830113220005
6201 Roosevelt Rd
Berwyn, IL 60402-1108
Phone (708) 386-0845
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080423000332 | IL | Practitioner - Certified Nurse Midwife (CNM) | 2365520988 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Midwife
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PCC Community Wellness Center | Current |
Accepting new patients | |
| PCC Community Wellness Center | Current |
Accepting new patients | |
| PCC Community Wellness Center | Past | Accepting new patients |
Locations
6201 Roosevelt Rd
Berwyn, IL 60402
Phone (708) 386-0845
14 Lake St
Oak Park, IL 60302
Phone (708) 383-0113
Interoperability endpoints
- annette.payot.1@13158.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 209006749 | IL | Yes |
Addresses
Primary practice location
6201 Roosevelt Rd
Berwyn, IL 60402-1108
Mailing address
6201 Roosevelt Rd
Berwyn, IL 60402-1108
Phone (708) 386-0845
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01621679 | Other | IL | BCBS GROUP |
| 209006749 | Other | IL | ILLINOIS LICENSE |
| 041345892 | Other | IL | MSN |
Other providers in Berwyn, IL
- Demetrios Patos
- Patriot Car Services, LLC
- Paul Potach D.P.M.,P.C.
- Kelli Paulson
- Justin James Payette
- PCC Community Wellness Center
- PCC Community Wellness Center
- Sharlyn Pech
- Joanna Pelayo
- Marleni Pelayo
All providers in Berwyn, IL · Advanced Practice Midwife in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.