Tracy Fairbanks Obrien, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

121 Issued in MN

Practice address

640 Jackson St
Saint Paul, MN 55101-2502

Phone

(952) 967-7619

Fax

(651) 602-7517

NPI assigned

Oct 18, 2012

Last updated

Nov 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Group Health, Inc.

  dba HealthPartners Medical Group

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment Care Compare group NPD
• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272
  Medicare reassignment Care Compare group NPD
• West Side Community Health Services, Inc.

  dba McDonough Homes Clinic

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1821149964
  Medicare reassignment NPD
• Group Health, Inc.

  dba HealthPartners Riverway Pain Clinic

  • Pain Clinic/Center
  • Anoka, MN
  • NPI 1689068462
  NPD
• Group Health, Inc.

  dba HealthPartners Midway Residency Dental

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• West Side Community Health Services, Inc.

  dba MINNESOTA COMMUNITY CARE MBC - St. Paul

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1043187289
  NPD
• West Side Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Saint Paul, MN
  • NPI 1407049653
  NPD
• Legacy Clinics LLC

  dba Legacy Medical Group Firwood

  • Rural Health Clinic/Center
  • Sandy, OR
  • NPI 1730472192
  NPD
• Legacy Emanuel Hospital & Health Center

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1831112358
  NPD (past)

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732579200000",
    "number": "1437402237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "address_2": "MS 21110Q",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 JACKSON ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551012502",
            "telephone_number": "952-967-7619",
            "fax_number": "651-602-7517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "TRACY",
        "middle_name": "FAIRBANKS",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "10013604",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimmy S Oberstar, CPNP, PMHS
• Michele Amanda Relton Obert, MD
• Elizabeth Chinwe Obi, RN
• Shannon Obi
• Linda Obiero, PHARMD
• Wendy Jean Obrien, RDN, LDN
• Mary Anne Obst
• Occupational Health Centers of Minnesota PC (Concentra Medical Center)
• Occupational Health Centers of Minnesota PC (Concentra Medical Center)
• Occupational Health Centers of the Southwest, P.a.

• Advanced Practice Midwife in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Advanced Practice Midwife in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.