Individual provider Active NPI

Cassandra Korth, CNM

  • Advanced Practice Midwife
  • San Tan Valley, AZ
National Provider Identifier
1447608724
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP8768 Issued in AZ
Practice address
37100 N Gantzel Rd Ste 106
San Tan Valley, AZ 85140-7350
Phone
(480) 821-3600
Fax
(480) 857-2667
NPI assigned
May 27, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X AP8768 AZ Primary

Addresses

Primary practice location

37100 N Gantzel Rd Ste 106
San Tan Valley, AZ 85140-7350

Mailing address

PO Box 6730
Chandler, AZ 85246-6730
Phone (480) 821-3600

Other identifiers 1

IdentifierTypeStateIssuer
170535MedicaidAZ

Other names 1

  • Cassandra Welch Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20160921000675 AZ Practitioner - Certified Nurse Midwife (CNM) 4587951413 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Momdoc LLCGroup PAC ID 3375534282, 62 clinicians

Practice addresses (Care Compare)

21300 N John Wayne Pkwy
Maricopa, AZ 85139-8978
Phone (480) 821-3600

37100 N Gantzel Rd
Suite 106
San Tan Valley, AZ 85140-7350
Phone (480) 821-3600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Pregnancy Perinatology, LLC Past Accepting new patients
Banner Ironwood Medical Center Past Accepting new patients

Organizations & group practices 3

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": "1464307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1447608724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6730",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852466730",
            "telephone_number": "480-821-3600",
            "fax_number": "480-857-2667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37100 N GANTZEL RD STE 106",
            "city": "SAN TAN VALLEY",
            "state": "AZ",
            "postal_code": "851407350",
            "telephone_number": "480-821-3600",
            "fax_number": "480-857-2667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORTH",
        "first_name": "CASSANDRA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-27",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "AP8768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170535",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "WELCH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Tan Valley, AZ

Sources for this page

Verify at the official NPI Registry.