Individual provider Active NPI

Sarah Elizabeth Kankiewicz, CPM, LM

  • Midwife
  • Mesa, AZ
National Provider Identifier
1649891359
Registry record updated May 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
LM230 Issued in AZ
Practice address
630 E Jensen St Unit 162
Mesa, AZ 85203-2594
Phone
(480) 788-4404
NPI assigned
May 4, 2020
Last updated
May 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X LM230 AZ Primary

Addresses

Primary practice location

630 E Jensen St Unit 162
Mesa, AZ 85203-2594

Mailing address

630 E Jensen St Unit 162
Mesa, AZ 85203-2594
Phone (480) 788-4404

Other identifiers 2

IdentifierTypeStateIssuer
19120001OtherNORTH AMERICAN REGISTRY OF MIDWIVES
LM230OtherAZARIZONA DEPARTMENT OF HEALTH SERVICES LICENCE

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

LicenseStateTypeSpecialty
LM230AZMDMidwife

NPI Registry JSON

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

{
    "created_epoch": "1588550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588550400000",
    "number": "1649891359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 E JENSEN ST UNIT 162",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032594",
            "telephone_number": "480-788-4404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E JENSEN ST UNIT 162",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852032594",
            "telephone_number": "480-788-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANKIEWICZ",
        "first_name": "SARAH",
        "middle_name": "ELIZABETH",
        "credential": "CPM, LM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-04",
        "last_updated": "2020-05-04",
        "certification_date": "2020-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "AZ",
            "license": "LM230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH AMERICAN REGISTRY OF MIDWIVES",
            "identifier": "19120001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA DEPARTMENT OF  HEALTH SERVICES LICENCE",
            "identifier": "LM230",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

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