Marissa Coronado, DEM

Primary specialty

Lay MidwifeTaxonomy code 175M00000X

Practice address

10886 S Shilling Ave Apt 2034
South Jordan, UT 84095-4334

Phone

(510) 305-5460

NPI assigned

Aug 4, 2020

Last updated

Aug 4, 2020By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1596499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596499200000",
    "number": "1629688734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10886 S SHILLING AVE APT 2034",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10886 S SHILLING AVE APT 2034",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840954334",
            "telephone_number": "510-305-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORONADO",
        "first_name": "MARISSA",
        "credential": "DEM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-04",
        "last_updated": "2020-08-04",
        "certification_date": "2020-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175M00000X",
            "taxonomy_group": "",
            "desc": "Midwife, Lay",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Www.homewardbirth@gmail.com",
            "affiliation": "N",
            "address_1": "10886 S Shilling Ave Apt 2034",
            "city": "South Jordan",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840954334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Lay Midwife in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Lay Midwife in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2020; 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.