Individual provider Active NPI

Heather Dawn Reynolds, CNM, MSN, FACNM

  • Advanced Practice Midwife
  • New Haven, CT
National Provider Identifier
1538160221
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
000042 Issued in CT
Practice address
20 York St
Women'S Center TMPB
New Haven, CT 06504-8900
Phone
(203) 688-4101
Fax
(203) 688-7274
NPI assigned
Aug 3, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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 000042 CT Primary

Addresses

Primary practice location

20 York St
Women'S Center TMPB
New Haven, CT 06504-8900

Mailing address

53 Sea St
New Haven, CT 06519-2813
Phone (203) 777-3607

Other identifiers 1

IdentifierTypeStateIssuer
004147452MedicaidCT

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, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
000042CTMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1538160221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 SEA ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065192813",
            "telephone_number": "203-777-3607",
            "fax_number": "203-785-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 YORK ST",
            "address_2": "WOMEN'S CENTER TMPB",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065048900",
            "telephone_number": "203-688-4101",
            "fax_number": "203-688-7274"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNOLDS",
        "first_name": "HEATHER",
        "middle_name": "DAWN",
        "name_prefix": "Ms.",
        "credential": "CNM, MSN, FACNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CT",
            "license": "000042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004147452",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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.