Individual provider Active NPI

Krista Noelle Wurlitzer, LM, CPM

  • Midwife
  • Redding, CA
National Provider Identifier
1518678564
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
LM695 Issued in CA
Practice address
845 Lakeview Dr
Redding, CA 96001-0316
Phone
(530) 680-2727
Fax
(530) 605-2725
NPI assigned
Dec 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X LM695 CA Primary

Addresses

Primary practice location

845 Lakeview Dr
Redding, CA 96001-0316

Mailing address

845 Lakeview Dr
Redding, CA 96001-0316
Phone (530) 680-2727

Other identifiers 1

IdentifierTypeStateIssuer
LM695OtherCALICENSE NUMBER

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

LicenseStateTypeSpecialty
LM695CAMDMidwife

NPI Registry JSON

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

{
    "created_epoch": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1518678564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 LAKEVIEW DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010316",
            "telephone_number": "530-680-2727",
            "fax_number": "530-605-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 LAKEVIEW DR",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960010316",
            "telephone_number": "530-680-2727",
            "fax_number": "530-605-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURLITZER",
        "first_name": "KRISTA",
        "middle_name": "NOELLE",
        "name_prefix": "Miss",
        "credential": "LM, CPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "LM695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "LM695",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.