Individual provider Active NPI

Tara Lynn Stokes, CNM

  • Advanced Practice Midwife
  • Elkhart, IN
National Provider Identifier
1508096363
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
72000067A Issued in IN
Practice address
1215 Lawn Ave
Suite 100
Elkhart, IN 46514-2450
Phone
(574) 293-2893
Fax
(574) 293-1298
NPI assigned
Jul 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 28138289A IN
Advanced Practice Midwife 367A00000X 72000067A IN Primary

Addresses

Primary practice location

1215 Lawn Ave
Suite 100
Elkhart, IN 46514-2450

Mailing address

PO Box 1887
Elkhart General Physician Services
Elkhart, IN 46515-1887
Phone (574) 389-0542

Other identifiers 3

IdentifierTypeStateIssuer
72000067BOtherINCSR
200353990OtherINMEDICAID
000000622176OtherINANTHEM

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)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
28138289AINMDRegistered Nurse
72000067AINMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Joseph Community Hospital of Mishawaka Past Accepting new patients
Saint Joseph Regional Medical Center-South Bend Campus, Inc. Past Accepting new patients

Organizations & group practices 2

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1508096363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1887",
            "address_2": "ELKHART GENERAL PHYSICIAN SERVICES",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465151887",
            "telephone_number": "574-389-0542",
            "fax_number": "574-522-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 LAWN AVE",
            "address_2": "SUITE 100",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142450",
            "telephone_number": "574-293-2893",
            "fax_number": "574-293-1298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOKES",
        "first_name": "TARA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28138289A",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IN",
            "license": "72000067A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSR",
            "identifier": "72000067B",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID",
            "identifier": "200353990",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000622176",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2009; 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.