Individual provider Active NPI

Jennifer Suzanne Grieco Desmarais, CPM, RM, LM

  • Midwife
  • Windsor, CO
National Provider Identifier
1598055774
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
LM298 Issued in CA
Practice address
1832 Windfall Dr.
Windsor, CO 80550
Phone
(949) 929-7153
NPI assigned
Apr 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
MidwifeGroup: 193400000X SINGLE SPECIALTY GROUP 176B00000X 298 CA
Midwife 176B00000X LM298 CA Primary

Addresses

Primary practice location

1832 Windfall Dr.
Windsor, CO 80550

Mailing address

1832 Windfall Dr.
Windsor, CO 80550
Phone (949) 929-7153

Other practice location 1

35756 Damascus St
Yucaipa, CA 92399-5113
Phone (909) 747-7750

Other practice location 2

36389 Highland Ave
Yucaipa, CA 92399-9727
Phone (949) 929-7153

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.jengrieco.com Direct

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
298CAMDMidwife
LM298CAMDMidwife

NPI Registry JSON

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669680000000",
    "number": "1598055774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1832 WINDFALL DR.",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "80550",
            "telephone_number": "949-929-7153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1832 WINDFALL DR.",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "80550",
            "telephone_number": "949-929-7153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35756 Damascus St",
            "address_purpose": "LOCATION",
            "city": "Yucaipa",
            "state": "CA",
            "postal_code": "923995113",
            "country_code": "US",
            "telephone_number": "909-747-7750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36389 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Yucaipa",
            "state": "CA",
            "postal_code": "923999727",
            "country_code": "US",
            "telephone_number": "949-929-7153",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIECO DESMARAIS",
        "first_name": "JENNIFER",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "CPM, RM, LM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-08",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Midwife",
            "state": "CA",
            "license": "298",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "LM298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.jengrieco.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1832 Windfall Dr.",
            "city": "Windsor",
            "state": "CO",
            "country_code": "US",
            "postal_code": "80550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Windsor, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.