Individual provider Active NPI

Brittany Mbong, CNM, WHNP

  • Advanced Practice Midwife
  • Clovis, CA
National Provider Identifier
1437617982
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
236023 Issued in CA
Practice address
726 N Medical Center Dr E Ste 221
Clovis, CA 93611-6886
Phone
(559) 322-2900
NPI assigned
Mar 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95011051 CA
Advanced Practice Midwife 367A00000X 236023 CA Primary

Addresses

Primary practice location

726 N Medical Center Dr E Ste 221
Clovis, CA 93611-6886

Mailing address

726 N Medical Center Dr E Ste 221
Clovis, CA 93611-6886
Phone (559) 322-2900

Other practice location 1

2201 Calaveras St
Fresno, CA 93721-1103
Phone (559) 767-1756

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20190918000957 CA Practitioner - Certified Nurse Midwife (CNM) 5395075337 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
95011051CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Sep 28, 2020 Accepting new patients
Ole Health CurrentSince Jul 13, 2020 Accepting new patients
Ole Health CurrentSince Jul 13, 2020 Accepting new patients
Ole Health Current Accepting new patients
Sutter Valley Medical Foundation CurrentSince Sep 28, 2020 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients

Locations

2051 John Jones Rd
Davis, CA 95616
Phone (530) 753-3498

2020 Sutter Pl
Ste 203
Davis, CA 95616
Phone (530) 750-5880

2035 Lyndell Ter
Ste 120
Davis, CA 95616
Phone (530) 750-5999

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

500 Jefferson Blvd
Ste B180
West Sacramento, CA 95605
Phone (916) 375-6400

215 W Beamer St
Woodland, CA 95695
Phone (530) 405-2800

Interoperability endpoints

  • Direct secure messaging: bedwards552944@hisp.ehr.sutterhealth.org
  • Direct secure messaging: bedwards675606@direct.ochin.org

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1551657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1437617982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "726 N MEDICAL CENTER DR E STE 221",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116886",
            "telephone_number": "559-322-2900",
            "fax_number": "530-758-2109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 N MEDICAL CENTER DR E STE 221",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936116886",
            "telephone_number": "559-322-2900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 Calaveras St",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937211103",
            "country_code": "US",
            "telephone_number": "559-767-1756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MBONG",
        "first_name": "BRITTANY",
        "credential": "CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-04",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95011051",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "236023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.