Active NPI
Nicole Pavlides, CNM
- Midwife
- Tucson, AZ
National Provider Identifier
1386719896
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- RN154574
- Practice address
- 2595 N Wyatt Dr
Tucson, AZ 85712-6104 - Phone
- (520) 795-9912
- Fax
- (520) 795-9934
- NPI assigned
- Nov 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | RN176972 | GA | |
| Midwife | 176B00000X | RN154574 | AZ | Primary |
Addresses
Primary practice location
2595 N Wyatt Dr
Tucson, AZ 85712-6104
Mailing address
2595 N Wyatt
Tucson, AZ 85712
Phone (520) 795-9912
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 390332 | Medicaid | AZ | |
| 536923623A | Medicaid | GA |
Other names 1
- Nicole Jackson
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN154574 | AZ | MD | Midwife |
| RN176972 | GA | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Associates in Women'S Health Care, PLLC | Past | Accepting new patients | |
| Birth and Womens Health Center Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Tucson, AZ
- NPI 1346273067
-
- Advanced Practice Midwife
- Tucson, AZ
- NPI 1750482386
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1231718400000",
"number": "1386719896",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2595 N WYATT",
"city": "TUCSON",
"state": "AZ",
"postal_code": "85712",
"telephone_number": "520-795-9912",
"fax_number": "520-795-9934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2595 N WYATT DR",
"city": "TUCSON",
"state": "AZ",
"postal_code": "857126104",
"telephone_number": "520-795-9912",
"fax_number": "520-795-9934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVLIDES",
"first_name": "NICOLE",
"name_prefix": "Ms.",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-21",
"last_updated": "2009-01-12",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "GA",
"license": "RN176972",
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "AZ",
"license": "RN154574",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "390332",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "536923623A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "JACKSON",
"credential": "CNM",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Tucson, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.