Individual provider Active NPI

Erin Tullock, CNM

  • Advanced Practice Midwife
  • North Conway, NH
National Provider Identifier
1508907320
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
230304 Issued in MA
Practice address
3073 White Mountain Hwy
North Conway, NH 03860-7101
Phone
(603) 356-9355
Fax
(603) 356-8843
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 230304 MA Primary

Addresses

Primary practice location

3073 White Mountain Hwy
North Conway, NH 03860-7101

Mailing address

PO Box 2190
North Conway, NH 03860-2190
Phone (603) 356-9355

Other identifiers 2

IdentifierTypeStateIssuer
0364631MedicaidMA
30462788MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080228000452 MA Practitioner - Certified Nurse Midwife (CNM) 3870581697 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass General Brigham Medical Group Suburban Massachusetts Inc 534 clinicians

Practice addresses (Care Compare)

2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Jun 8, 2022 Accepting new patients
Neighborhealth Corporation CurrentSince Oct 18, 2021 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Internal Medical Associates-Ebnhc CurrentSince Oct 18, 2021 Accepting new patients
Brigham & Womens Hospital, Inc. CurrentSince Aug 3, 2021 Accepting new patients
Seacoast Affiliated Group Practice, Inc. Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

Interoperability endpoints

  • Direct secure messaging: tullock.erin.bwh@direct.partners.masshiway.net

Organizations & group practices 7

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350259200000",
    "number": "1508907320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2190",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038602190",
            "telephone_number": "603-356-9355",
            "fax_number": "603-356-8843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3073 WHITE MOUNTAIN HWY",
            "city": "NORTH CONWAY",
            "state": "NH",
            "postal_code": "038607101",
            "telephone_number": "603-356-9355",
            "fax_number": "603-356-8843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULLOCK",
        "first_name": "ERIN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2012-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "230304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0364631",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30462788",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Conway, NH

Sources for this page

Verify at the official NPI Registry.