NPIMap

Organization Active NPI

Johanna Congleton, CNM, PA

  • Advanced Practice Midwife
  • Dallas, TX
National Provider Identifier
1447672357
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
CNM1795 Issued in TX
Legal business name
JOHANNA CONGLETON, CNM, PA
Practice address
9 Medical Pkwy Plaza 4
Ste 103
Dallas, TX 75234-7858
Phone
(972) 406-9911
Fax
(972) 406-9930
NPI assigned
Jan 11, 2014
Last updated
Jul 27, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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

Authorized official

Name
Malathi Ellis, MDNPI 1861509275
Title
Provider/Owner
Phone
(972) 406-9911

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X CNM1795 TX Primary

Addresses

Primary practice location

9 Medical Pkwy Plaza 4
Ste 103
Dallas, TX 75234-7858

Mailing address

6750 N Macarthur Blvd
100
Irving, TX 75039-2875
Phone (972) 406-9911

Other identifiers 3

IdentifierTypeStateIssuer
744687OtherTXNURSE LICENSE #
15228OtherTXRX AUTH #
345079301MedicaidTX

National Provider Directory

National Provider Directory

Locations

9 Medical Pkwy
Ste 103
Dallas, TX 75234
Phone (972) 243-6568

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1389398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437955200000",
    "number": "1447672357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6750 N MACARTHUR BLVD",
            "address_2": "100",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392875",
            "telephone_number": "972-406-9911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MEDICAL PKWY PLAZA 4",
            "address_2": "STE 103",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347858",
            "telephone_number": "972-406-9911",
            "fax_number": "972-406-9930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHANNA CONGLETON, CNM, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-11",
        "last_updated": "2015-07-27",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "MALATHI",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "972-406-9911",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "CNM1795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE LICENSE #",
            "identifier": "744687",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RX AUTH #",
            "identifier": "15228",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "345079301",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; 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.