Individual provider Active NPI

Marcie S Mullins, CNM

  • Advanced Practice Midwife
  • Boulder, CO
National Provider Identifier
1457717415
Registry record updated Aug 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APN.0994898-CNM Issued in CO
Practice address
4745 Arapahoe Ave Ste 140
Boulder, CO 80303
Phone
(303) 415-4045
Fax
(303) 415-4046
NPI assigned
Jan 6, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2019

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 APN.0994898-CNM CO Primary

Addresses

Primary practice location

4745 Arapahoe Ave Ste 140
Boulder, CO 80303

Mailing address

5450 Western Ave
Boulder, CO 80301-2709
Phone (303) 415-4045

Other practice location 1

15959 Hall Rd
Suite 301
Macomb, MI 48044-5363
Phone (586) 247-8609

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20190918003526 CO Practitioner - Certified Nurse Midwife (CNM) 4486984374 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0994898-CNMCOMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Boulder Community Health Current Accepting new patients
Boulder Community Health CurrentSince Aug 26, 2019 Accepting new patients
Boulder Community Health CurrentSince Aug 26, 2019 Accepting new patients
Partridge Creek Obstetrics & Gynecology,P.C. Obstetrics & Gynecology PastSince May 1, 2008 Accepting new patients
Boulder Community Health Past Accepting new patients

Locations

4745 Arapahoe Ave
Ste 140
Boulder, CO 80303
Phone (303) 415-4045

5450 Western Ave
Boulder, CO 80301
Phone (303) 415-4770

4840 Riverbend Rd
Ste 100
Boulder, CO 80301
Phone (303) 415-4045

1755 48th St
Ste 200
Boulder, CO 80301
Phone (303) 415-7450

101 Erie Pkwy
Erie, CO 80516
Phone (303) 415-5170

101 Erie Pkwy
Ste 201D
Erie, CO 80516
Phone (303) 415-4045

Organizations & group practices 5

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": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1457717415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WESTERN AVE",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803012709",
            "telephone_number": "303-415-4045",
            "fax_number": "303-415-4046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4745 ARAPAHOE AVE STE 140",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80303",
            "telephone_number": "303-415-4045",
            "fax_number": "303-415-4046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15959 Hall Rd",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "Macomb",
            "state": "MI",
            "postal_code": "480445363",
            "country_code": "US",
            "telephone_number": "586-247-8609",
            "fax_number": "586-247-8615",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MULLINS",
        "first_name": "MARCIE",
        "middle_name": "S",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-06",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CO",
            "license": "APN.0994898-CNM",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

Verify at the official NPI Registry.