Carol Jean Dehaven, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

R063454 Issued in MD

Practice address

23000 Moakley St
Suite 203
Leonardtown, MD 20650-2915

Phone

(301) 475-8599

Fax

(301) 475-1514

NPI assigned

Jun 11, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

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.

• Lawrence E Tilley, Mdpa

  • Obstetrics & Gynecology Physician
  • Leonardtown, MD
  • NPI 1609044197
  NPD (past)

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609079110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1536",
            "address_2": "6600 HAWKINS GATE ROAD",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206461536",
            "telephone_number": "301-392-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23000 MOAKLEY ST",
            "address_2": "SUITE 203",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502915",
            "telephone_number": "301-475-8599",
            "fax_number": "301-475-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEHAVEN",
        "first_name": "CAROL",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MD",
            "license": "R063454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Advanced Practice Midwife in Leonardtown, MD
• Providers in Leonardtown, MD by specialty
• Advanced Practice Midwife in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.