Mermaid Birth, LLC

Primary specialty

Birthing Clinic/CenterTaxonomy code 261QB0400X

License

UT000782 Issued in UT

Legal business name

MERMAID BIRTH, LLC

Practice address

48 S 100 E
Brigham City, UT 84302-2642

Phone

(801) 643-0604

Fax

(435) 279-9092

NPI assigned

Feb 19, 2014

Organization subpart

No

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

Authorized official

Name

Danielle M Chancellor-Checketts, CPM-LDEM

Title

Owner/Midwife

Phone

(801) 643-0604

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1392768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479254400000",
    "number": "1417372095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 S 100 E",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843022642",
            "telephone_number": "801-643-0604",
            "fax_number": "435-279-9092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 S 100 E",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843022642",
            "telephone_number": "801-643-0604",
            "fax_number": "435-279-9092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERMAID BIRTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-19",
        "last_updated": "2016-11-16",
        "status": "A",
        "authorized_official_last_name": "CHANCELLOR-CHECKETTS",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/MIDWIFE",
        "authorized_official_telephone_number": "801-643-0604",
        "authorized_official_credential": "CPM-LDEM"
    },
    "taxonomies": [
        {
            "code": "261QB0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Birthing",
            "state": "UT",
            "license": "UT000782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medical Arts Center Clinic of Brigham City Inc
• C Kai Medina Martinez, LCSW
• Sandra Medina
• Raylee Meeds
• Michelle Mehl
• Stanton Glacus Merrill
• Leland W Messersmith, LCSW
• Keirstin Meyer, MS
• Catherine Michelle Mihlfeith, PA-C
• James Miller

• Birthing Clinic/Center in Brigham City, UT
• Providers in Brigham City, UT by specialty
• Birthing Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2016; 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.