Individual provider Active NPI

Danielle Nichole Nazarenko, CNM

  • Advanced Practice Midwife
  • Marblehead, MA
National Provider Identifier
1619411691
Registry record updated Dec 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN2281988 Issued in MA
Practice address
27 Smith Street
#233
Marblehead, MA 01945-4500
Phone
(781) 797-0762
Fax
(413) 642-2563
NPI assigned
Dec 12, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN2281988 MA Primary
Doula 374J00000X

Addresses

Primary practice location

27 Smith Street
#233
Marblehead, MA 01945-4500

Mailing address

27 Smith St # 233
Marblehead, MA 01945-4500
Phone (781) 797-0762

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
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN2281988MAMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543795200000",
    "number": "1619411691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 SMITH ST # 233",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019454500",
            "telephone_number": "781-797-0762",
            "fax_number": "413-642-2563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 SMITH STREET",
            "address_2": "#233",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019454500",
            "telephone_number": "781-797-0762",
            "fax_number": "413-642-2563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAZARENKO",
        "first_name": "DANIELLE",
        "middle_name": "NICHOLE",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-12",
        "last_updated": "2018-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN2281988",
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marblehead, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.