Individual provider Active NPI

Kerry Raghib, CNM, MSN

  • Advanced Practice Midwife
  • Williston, ND
National Provider Identifier
1649217043
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
R16780 Issued in ND
Practice address
1700 11TH St W
Williston, ND 58801-4500
Phone
(701) 774-7687
Fax
(701) 572-1695
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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 R16780 ND Primary

Addresses

Primary practice location

1700 11TH St W
Williston, ND 58801-4500

Mailing address

1700 11TH St W
Williston, ND 58801-4500
Phone (701) 774-7687

Other identifiers 1

IdentifierTypeStateIssuer
19616MedicaidND

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, Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
R16780NDMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Joshua G Yorgason MD PLLC PastSince Aug 1, 2012 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1649217043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 11TH ST W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588014500",
            "telephone_number": "701-774-7687",
            "fax_number": "701-572-1695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 11TH ST W",
            "city": "WILLISTON",
            "state": "ND",
            "postal_code": "588014500",
            "telephone_number": "701-774-7687",
            "fax_number": "701-572-1695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGHIB",
        "first_name": "KERRY",
        "name_prefix": "Ms.",
        "credential": "CNM, MSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "ND",
            "license": "R16780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19616",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Williston, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.