Individual provider Active NPI

Elaine K Anderson, CNM

  • Advanced Practice Midwife
  • Bremerton, WA
National Provider Identifier
1629226402
Registry record updated Sep 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP30004182 Issued in WA
Practice address
1 Boone Rd
Bremerton, WA 98312-1894
Phone
(360) 475-4209
NPI assigned
Sep 4, 2008
Last updated
Sep 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2008

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X AP30004182 WA Primary
Advanced Practice Midwife 367A00000X 732 CA
Advanced Practice Midwife 367A00000X 610038 TX
Advanced Practice Midwife 367A00000X 9116 VI
Advanced Practice Midwife 367A00000X 67496 LA

Addresses

Primary practice location

1 Boone Rd
Bremerton, WA 98312-1894

Mailing address

8270 Tideland Way
Clinton, WA 98236-8936
Phone (360) 579-2580

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)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
732CAMDMental Health Counselor
67496LAMDAdvanced Practice Midwife
610038TXMDAdvanced Practice Midwife
9116VIMDAdvanced Practice Midwife
AP30004182WAMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220486400000",
    "number": "1629226402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8270 TIDELAND WAY",
            "city": "CLINTON",
            "state": "WA",
            "postal_code": "982368936",
            "telephone_number": "360-579-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BOONE RD",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983121894",
            "telephone_number": "360-475-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ELAINE",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2008-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP30004182",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "732",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "610038",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "VI",
            "license": "9116",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "LA",
            "license": "67496",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bremerton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2008; 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.