Active NPI
Patty Jean Kandiko, CNM
- Advanced Practice Midwife
- Grand Junction, CO
National Provider Identifier
1649515685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- Practice address
- 2241 N 7TH St
Grand Junction, CO 81501-7423 - Phone
- (970) 549-1711
- Fax
- (970) 314-2633
- NPI assigned
- Dec 3, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 0990542 | CO | |
| Advanced Practice Midwife | 367A00000X | Primary |
Addresses
Primary practice location
2241 N 7TH St
Grand Junction, CO 81501-7423
Mailing address
2241 N 7TH St
Grand Junction, CO 81501-7423
Phone (970) 549-1711
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 330749YXN7 | Other | CO | MEDICARE ID |
| 62975862 | Medicaid | CO |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bloomin' Babies Birth Center, LLC | Midwife | Past | Accepting new patients |
| Bloomin Babies Birth Center LLC | Past | 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.
-
- Birthing Clinic/Center
- Grand Junction, CO
- NPI 1992043996
-
- Advanced Practice Midwife
- Grand Junction, CO
- NPI 1720459894
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566432000000",
"number": "1649515685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2241 N 7TH ST",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815017423",
"telephone_number": "970-549-1711",
"fax_number": "970-314-2633"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2241 N 7TH ST",
"city": "GRAND JUNCTION",
"state": "CO",
"postal_code": "815017423",
"telephone_number": "970-549-1711",
"fax_number": "970-314-2633"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANDIKO",
"first_name": "PATTY",
"middle_name": "JEAN",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-12-03",
"last_updated": "2019-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CO",
"license": "0990542",
"primary": false
},
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID",
"identifier": "330749YXN7",
"state": "CO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "62975862",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Junction, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.