Active NPI
Brieana Davison, CPM LM
- Midwife
- Maplewood, MN
National Provider Identifier
1649638099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 1093
- Practice address
- 1885 Howard St N
Maplewood, MN 55109-4844 - Phone
- (951) 397-6264
- Fax
- (651) 447-7873
- NPI assigned
- Jan 31, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 503-49 | WI | |
| Midwife | 176B00000X | 1093 | MN | Primary |
| Midwife | 176B00000X | CPM22070019 | ||
| Doula | 374J00000X | MN | ||
| Doula | 374J00000X | CA |
Addresses
Primary practice location
1885 Howard St N
Maplewood, MN 55109-4844
Mailing address
1885 Howard St N
Maplewood, MN 55109-4844
Phone (612) 367-7939
Other practice location 1
2606 Chicago Ave
Minneapolis, MN 55407-3706
Phone (612) 545-5311
Other practice location 2
624 Smith Ave S
Saint Paul, MN 55107-2620
Phone (651) 698-3988
Other names 1
- Brieana Davison
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 503-49 | WI | MD | Midwife |
| 1093 | MN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Le Gra Birth Services, LLC | Midwife | 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 and National Provider Directory roles.
-
- Midwife
- Maplewood, MN
- NPI 1205671104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719792000000",
"number": "1649638099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1885 HOWARD ST N",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551094844",
"telephone_number": "612-367-7939",
"fax_number": "651-447-7873"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1885 HOWARD ST N",
"city": "MAPLEWOOD",
"state": "MN",
"postal_code": "551094844",
"telephone_number": "951-397-6264",
"fax_number": "651-447-7873"
}
],
"practiceLocations": [
{
"address_1": "2606 Chicago Ave",
"address_purpose": "LOCATION",
"city": "Minneapolis",
"state": "MN",
"postal_code": "554073706",
"country_code": "US",
"telephone_number": "612-545-5311",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "624 Smith Ave S",
"address_purpose": "LOCATION",
"city": "Saint Paul",
"state": "MN",
"postal_code": "551072620",
"country_code": "US",
"telephone_number": "651-698-3988",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DAVISON",
"first_name": "BRIEANA",
"credential": "CPM LM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-01-31",
"last_updated": "2024-07-01",
"certification_date": "2024-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "WI",
"license": "503-49",
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "MN",
"license": "1093",
"primary": true
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": null,
"license": "CPM22070019",
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "MN",
"license": null,
"primary": false
},
{
"code": "374J00000X",
"taxonomy_group": "",
"desc": "Doula",
"state": "CA",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "BRIEANA",
"last_name": "DAVISON",
"credential": "CPM LM",
"code": "2",
"type": "Professional Name"
}
]
}
Other providers in Maplewood, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.