Active NPI
Elizabeth Moore, CPM LM
- Midwife
- Cazenovia, WI
National Provider Identifier
1508314691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 154-49
- Practice address
- 11029 Quaker Valley Rd
Cazenovia, WI 53924-8214 - Phone
- (608) 415-7813
- NPI assigned
- Sep 17, 2016
- Last updated
- Sep 17, 2016
- Sex
- Female
- Sole proprietor
- Yes
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 | 154-49 | WI | Primary |
Addresses
Primary practice location
11029 Quaker Valley Rd
Cazenovia, WI 53924-8214
Mailing address
11029 Quaker Valley Rd
P.O. Box 235
Cazenovia, WI 53924-8214
Phone (608) 415-7813
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15070010 | Other | THE NORTH AMERICAN REGISTRY OF MIDWIVES | |
| 154-49 | Other | WI | STATE OF WISCONSIN LICENSE |
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 |
|---|---|---|---|
| 154-49 | WI | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1474070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474070400000",
"number": "1508314691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11029 QUAKER VALLEY RD",
"address_2": "P.O. BOX 235",
"city": "CAZENOVIA",
"state": "WI",
"postal_code": "539248214",
"telephone_number": "608-415-7813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11029 QUAKER VALLEY RD",
"city": "CAZENOVIA",
"state": "WI",
"postal_code": "539248214",
"telephone_number": "608-415-7813"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "ELIZABETH",
"credential": "CPM LM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-17",
"last_updated": "2016-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "WI",
"license": "154-49",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "THE NORTH AMERICAN REGISTRY OF MIDWIVES",
"identifier": "15070010",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE OF WISCONSIN LICENSE",
"identifier": "154-49",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cazenovia, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.