Individual provider Active NPI

Krystel Lejoia Wilkins, CNM

  • Midwife
  • Davis, CA
National Provider Identifier
1609439082
Registry record updated Jul 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
236019 Issued in CA
Practice address
2020 Sutter PL Ste 203B
Davis, CA 95616-6213
Phone
(530) 750-5880
NPI assigned
Apr 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 236019 CA Primary

Addresses

Primary practice location

2020 Sutter PL Ste 203B
Davis, CA 95616-6213

Mailing address

1520 E Covell Blvd
Ste B5 #609
Davis, CA 95616

Other practice location 1

2051 John Jones Rd
Davis, CA 95616
Phone (530) 758-2060

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
I20191121000985 CA Practitioner - Certified Nurse Midwife (CNM) 2668804113 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
236019CAMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Valley Medical Foundation CurrentSince Jun 10, 2023 Accepting new patients
Ole Health CurrentSince Jul 11, 2024 Accepting new patients
Ole Health Current Accepting new patients
Ole Health CurrentSince Jul 11, 2024 Accepting new patients
Sutter North Medical Foundation Past Accepting new patients
Sutter Valley Hospitals Past Accepting new patients
Ole Health Past Accepting new patients

Locations

2051 John Jones Rd
Davis, CA 95616
Phone (530) 753-3498

1141 Pear Tree Ln
Ste 100
Napa, CA 94558
Phone (707) 254-1778

2800 L St
Ste 500
Sacramento, CA 95816
Phone (916) 454-6850

Interoperability endpoints

  • Direct secure messaging: kwilkins430339@hisp.ehr.sutterhealth.org

Organizations & group practices 7

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": "1555804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1609439082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 E COVELL BLVD",
            "address_2": "STE B5 #609",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "95616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 SUTTER PL STE 203B",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956166213",
            "telephone_number": "530-750-5880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2051 John Jones Rd",
            "address_purpose": "LOCATION",
            "city": "Davis",
            "state": "CA",
            "postal_code": "95616",
            "country_code": "US",
            "telephone_number": "530-758-2060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "KRYSTEL",
        "middle_name": "LEJOIA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-21",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "236019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.