Individual provider Active NPI

Fabiola Merchant, CNM, ANP

  • Advanced Practice Midwife
  • Cottonwood, AZ
National Provider Identifier
1629546601
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
218773 Issued in AZ
Practice address
203 S Candy LN Ste 6Ab
Cottonwood, AZ 86326-4120
Phone
(928) 634-0391
Fax
(928) 634-6145
NPI assigned
Nov 7, 2018
Last updated
Jun 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 218773 AZ
Advanced Practice Midwife 367A00000X 218773 AZ Primary
Obstetrics Physician 207VX0000X 218773 AZ

Addresses

Primary practice location

203 S Candy LN Ste 6Ab
Cottonwood, AZ 86326-4120

Mailing address

203 S Candy LN Ste 6Ab
Cottonwood, AZ 86326-4120
Phone (928) 634-0391

Other identifiers 1

IdentifierTypeStateIssuer
218773OtherAZLICENSE

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
218773AZMDObstetrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Healing Clinic Single Specialty Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1629546601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S CANDY LN STE 6AB",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264120",
            "telephone_number": "928-634-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S CANDY LN STE 6AB",
            "city": "COTTONWOOD",
            "state": "AZ",
            "postal_code": "863264120",
            "telephone_number": "928-634-0391",
            "fax_number": "928-634-6145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "FABIOLA",
        "credential": "CNM, ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "218773",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "218773",
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "AZ",
            "license": "218773",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "218773",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cottonwood, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.