Lily Dandy Bultema, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

5878 Issued in CO

Practice address

1650 Cochrane Cir
Ft Carson, CO 80913-4603

Phone

(719) 526-7746

NPI assigned

Jan 15, 2009

Last updated

Nov 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1508003351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 N CASCADE AVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809032305",
            "telephone_number": "719-659-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR",
            "city": "FT CARSON",
            "state": "CO",
            "postal_code": "809134603",
            "telephone_number": "719-526-7746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULTEMA",
        "first_name": "LILY",
        "middle_name": "DANDY",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-15",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CO",
            "license": "5878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheyenne Marie Buchanan, DENTAL ASSISTANT
• Cynthia Buchanan, FNP
• Emily Christine Buck, MD
• Ryan Bucknam, M.D.
• Katherine Buechner
• Shane R Burgess, PT, DPT
• Matthew Joseph Burke, MD, PHD
• John Butera, RMT PTA
• Mercedes Marie Butitta, CNM
• Deepthi Venkat Byreddy, M.D.

• Advanced Practice Midwife in Fort Carson, CO
• Providers in Fort Carson, CO by specialty
• Advanced Practice Midwife in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.