Meredith M Wallis, CNM, ANP

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

1247 Issued in AK

Practice address

418 Harris St
Ste. 316
Juneau, AK 99801-1083

Phone

(505) 681-7769

Fax

(877) 299-7953

NPI assigned

Aug 24, 2011

Last updated

Sep 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife

State licenses

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

• Moonrise Midwifery and Women's Health, LLC

  • Health Service Clinic/Center
  • Juneau, AK
  • NPI 1306245246
  Authorized official Same address or phone

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1669752481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 HARRIS ST",
            "address_2": "STE. 316",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998011083",
            "telephone_number": "505-681-7769",
            "fax_number": "877-299-7953"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 HARRIS ST",
            "address_2": "STE. 316",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998011083",
            "telephone_number": "505-681-7769",
            "fax_number": "877-299-7953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "MEREDITH",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "CNM, ANP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-24",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AK",
            "license": "1247",
            "primary": true
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AK",
            "license": "1247",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "33265",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher Shawn Wallace, O.D.
• Christy J Wallace, RD, LD
• Erin Wallace
• Xavier Wallace
• Joan Waller, LMT
• Laura Walsh
• Charlotte Ann Walter
• Rachel Bret Wasserman
• Susan Elaine Wastell, R.N.
• Naomi Michelle Watkins, LCSW

• Advanced Practice Midwife in Juneau, AK
• Providers in Juneau, AK by specialty
• Advanced Practice Midwife in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.