Individual provider Active NPI

Kathryn Elaine Newburn, CNM, RNP

  • Advanced Practice Midwife
  • Santa Rosa, CA
National Provider Identifier
1508882226
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
636 Issued in CA
Practice address
583 Summerfield Rd
Santa Rosa, CA 95405-5239
Phone
(707) 539-1544
NPI assigned
Jul 14, 2006
Last updated
Oct 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 259066 CA
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 259066 CA
Advanced Practice Midwife 367A00000X 636 CA Primary

Addresses

Primary practice location

583 Summerfield Rd
Santa Rosa, CA 95405-5239

Mailing address

1301 Sanchez Ave
Burlingame, CA 94010-3643
Phone (650) 347-0801

Other identifiers 2

IdentifierTypeStateIssuer
NP0048230MedicaidCA
NMW006360MedicaidCA

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
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
636CAMDAnesthesiology Physician
259066CAMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1508882226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SANCHEZ AVE",
            "city": "BURLINGAME",
            "state": "CA",
            "postal_code": "940103643",
            "telephone_number": "650-347-0801",
            "fax_number": "650-347-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "583 SUMMERFIELD RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954055239",
            "telephone_number": "707-539-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWBURN",
        "first_name": "KATHRYN",
        "middle_name": "ELAINE",
        "name_prefix": "Ms.",
        "credential": "CNM, RNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "259066",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "CA",
            "license": "259066",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP0048230",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NMW006360",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; 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.