Active NPI
Kim Raleigh Prairie, CNM
- Advanced Practice Midwife
- Albuquerque, NM
National Provider Identifier
1689817637
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 578
- Practice address
- 101 Hospital Loop NE Ste 105
Albuquerque, NM 87109-2100 - Phone
- (505) 843-6168
- Fax
- (505) 792-1978
- NPI assigned
- Apr 7, 2009
- Last updated
- Jul 21, 2020
- 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 |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 578 | NM | Primary |
| Registered Nurse | 163W00000X | R35843 | NM |
Addresses
Primary practice location
101 Hospital Loop NE Ste 105
Albuquerque, NM 87109-2100
Mailing address
6320 Riverside Plaza LN NW Ste B
Albuquerque, NM 87120-1710
Phone (505) 843-6168
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35987359 | Medicaid | NM |
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 |
|---|---|---|---|
| Women's Specialists of New Mexico | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.779
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Gynecology Physician
- Albuquerque, NM
- NPI 1053337147
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239062400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595289600000",
"number": "1689817637",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6320 RIVERSIDE PLAZA LN NW STE B",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871201710",
"telephone_number": "505-843-6168",
"fax_number": "505-792-1978"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 HOSPITAL LOOP NE STE 105",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871092100",
"telephone_number": "505-843-6168",
"fax_number": "505-792-1978"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRAIRIE",
"first_name": "KIM",
"middle_name": "RALEIGH",
"name_prefix": "Mrs.",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-07",
"last_updated": "2020-07-21",
"certification_date": "2020-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "NM",
"license": "578",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NM",
"license": "R35843",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "35987359",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.