Active NPI
Katie Petersen, CPM, LDM
- Midwife
- Grants Pass, OR
National Provider Identifier
1497569784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- LD-10252254
- Practice address
- 1453 Redwood Cir
Grants Pass, OR 97527-5523 - Phone
- (541) 916-8333
- Fax
- (541) 843-1010
- NPI assigned
- Feb 5, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | LD-10252254 | OR | Primary |
Addresses
Primary practice location
1453 Redwood Cir
Grants Pass, OR 97527-5523
Mailing address
1453 Redwood Cir
Grants Pass, OR 97527-5523
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD-10252254 | OR | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1738713600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1738713600000",
"number": "1497569784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1453 REDWOOD CIR",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275523"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1453 REDWOOD CIR",
"city": "GRANTS PASS",
"state": "OR",
"postal_code": "975275523",
"telephone_number": "541-916-8333",
"fax_number": "541-843-1010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETERSEN",
"first_name": "KATIE",
"credential": "CPM, LDM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-05",
"last_updated": "2025-02-05",
"certification_date": "2025-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "OR",
"license": "LD-10252254",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grants Pass, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.