Individual provider Active NPI

Katherine M Smolley, CNM

  • Advanced Practice Midwife
  • San Leandro, CA
National Provider Identifier
1588804827
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
1804 Issued in CA
Practice address
16110 E 14TH St
San Leandro, CA 94578-3002
Phone
(510) 398-7500
NPI assigned
Feb 26, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

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 1804 CA Primary

Addresses

Primary practice location

16110 E 14TH St
San Leandro, CA 94578-3002

Mailing address

16110 E 14TH St
San Leandro, CA 94578-3002
Phone (510) 398-7500

Other names 1

  • Katherine M Thanawala Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150805006776 CA Practitioner - Certified Nurse Midwife (CNM) 9032423058 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1804CAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Tiburcio Vasquez Health Center, Inc. CurrentSince Oct 4, 2022 Accepting new patients
Tiburcio Vasquez Health Center, Inc. CurrentSince Oct 4, 2022 Accepting new patients
Tiburcio Vasquez Health Center, Inc. Current Accepting new patients
Baby and Company Cary 1 LLC Past Accepting new patients
Maternity Centers of America LLC Past Accepting new patients

Locations

16110 E 14th St
Ashland, CA 94578
Phone (510) 398-7500

33255 9th St
Union City, CA 94587
Phone (510) 690-6052

Interoperability endpoints

  • Direct secure messaging: kthanawala600221@direct.ochin.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718841600000",
    "number": "1588804827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16110 E 14TH ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945783002",
            "telephone_number": "510-398-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16110 E 14TH ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945783002",
            "telephone_number": "510-398-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMOLLEY",
        "first_name": "KATHERINE",
        "middle_name": "M",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-26",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "THANAWALA",
            "middle_name": "M",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Leandro, CA

Sources for this page

Verify at the official NPI Registry.