Organization Active NPI

Riverbend Midwifery, LLC

  • Midwife
  • Live Oak, FL
National Provider Identifier
1386340941
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
Legal business name
RIVERBEND MIDWIFERY, LLC
Practice address
2010 Evergreen Ave SW
Live Oak, FL 32064-4421
Phone
(386) 984-9716
Fax
(386) 401-2312
NPI assigned
Feb 6, 2023
Last updated
Feb 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Authorized official

Name
Rosalie Blackwell, LM
Title
Owner
Phone
(386) 984-9716

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X NU Primary

Addresses

Primary practice location

2010 Evergreen Ave SW
Live Oak, FL 32064-4421

Mailing address

PO Box 1002
Lake City, FL 32056-1002

Other identifiers 1

IdentifierTypeStateIssuer
112949400MedicaidFL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1386340941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1002",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320561002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 EVERGREEN AVE SW",
            "city": "LIVE OAK",
            "state": "FL",
            "postal_code": "320644421",
            "telephone_number": "386-984-9716",
            "fax_number": "386-401-2312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERBEND MIDWIFERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "BLACKWELL",
        "authorized_official_first_name": "ROSALIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "386-984-9716",
        "authorized_official_credential": "LM"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112949400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Live Oak, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.