Individual provider Active NPI

Mary Louise Allen, CNM

  • Advanced Practice Midwife
  • West Palm Beach, FL
National Provider Identifier
1639371958
Registry record updated Jan 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
9244332 Issued in FL
Practice address
927 45TH St
Suite 303
West Palm Beach, FL 33407-2450
Phone
(561) 881-5454
NPI assigned
May 31, 2007
Last updated
Jan 20, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 9244332 FL Primary

Addresses

Primary practice location

927 45TH St
Suite 303
West Palm Beach, FL 33407-2450

Mailing address

2979 Pga Blvd
Suite 200
Palm Beach Gardens, FL 33410-2911
Phone (561) 275-7604

Other identifiers 1

IdentifierTypeStateIssuer
308010200MedicaidFL

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
9244332FLMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390176000000",
    "number": "1639371958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2979 PGA BLVD",
            "address_2": "SUITE 200",
            "city": "PALM BEACH GARDENS",
            "state": "FL",
            "postal_code": "334102911",
            "telephone_number": "561-275-7604",
            "fax_number": "561-802-5385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "927 45TH ST",
            "address_2": "SUITE 303",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334072450",
            "telephone_number": "561-881-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "MARY",
        "middle_name": "LOUISE",
        "name_prefix": "Miss",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2014-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "9244332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "308010200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2014; 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.