Carol Bryan, CNM NP PP

Primary specialty

MidwifeTaxonomy code 176B00000X

License

NMW1244 Issued in CA

Practice address

1672 Church Ave
McKinleyville, CA 95519-2504

Phone

(530) 625-4349

NPI assigned

Nov 28, 2006

Last updated

Oct 11, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Nurse Practitioner

State licenses

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1558437608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1672 CHURCH AVE",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955194203",
            "telephone_number": "530-625-4349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1672 CHURCH AVE",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955192504",
            "telephone_number": "530-625-4349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYAN",
        "first_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "CNM NP PP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OR",
            "license": "200150068NP",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "279942",
            "primary": false
        },
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CA",
            "license": "447699",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "NMW1244",
            "primary": true
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "OR",
            "license": "200510068NP",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000853",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Devon Thomas Burg, MA
• Deann Sabrina Campbell, NP
• Carelink Medical Transportation LLC
• Trevor E Carlson, PT

• Midwife in McKinleyville, CA
• Providers in McKinleyville, CA by specialty
• Midwife in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.