Individual provider Active NPI

Janna Lee Ekholm, CMW

  • Advanced Practice Midwife
  • San Marcos, CA
National Provider Identifier
1588977151
Registry record updated Jul 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
1894 Issued in CA
Practice address
150 Valpreda Rd
San Marcos, CA 92069-2973
Phone
(760) 736-6700
Fax
(760) 736-6782
NPI assigned
Jul 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2015

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 1894 CA Primary

Addresses

Primary practice location

150 Valpreda Rd
San Marcos, CA 92069-2973

Mailing address

150 Valpreda Rd
San Marcos, CA 92069-2973
Phone (760) 736-6700

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
I20110421000249 CA Practitioner - Certified Nurse Midwife (CNM) 8729263561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, 2,047 clinicians

Practice addresses (Care Compare)

200 W Arbor Dr
San Diego, CA 92103-1910
Phone (858) 249-6753

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Advanced Practice Midwife CurrentSince May 11, 2015 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the University of California CurrentSince May 11, 2015 Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients
Regents of the University of California Past Accepting new patients

Locations

9350 Campus Point Dr
La Jolla, CA 92037
Phone (858) 657-0583

8910 Villa La Jolla Dr
#200
La Jolla, CA 92037
Phone (858) 657-8745

16950 Via Tazon
San Diego, CA 92127
Phone (858) 521-2265

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

150 Valpreda Rd
San Marcos, CA 92069
Phone (619) 736-6700

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436745600000",
    "number": "1588977151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 VALPREDA RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692973",
            "telephone_number": "760-736-6700",
            "fax_number": "760-736-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 VALPREDA RD",
            "city": "SAN MARCOS",
            "state": "CA",
            "postal_code": "920692973",
            "telephone_number": "760-736-6700",
            "fax_number": "760-736-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKHOLM",
        "first_name": "JANNA",
        "middle_name": "LEE",
        "credential": "CMW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-23",
        "last_updated": "2015-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Marcos, CA

Sources for this page

Verify at the official NPI Registry.