Active NPI
Marlissa Hinkle Ivers, CPM, LM
- Midwife
- San Diego, CA
National Provider Identifier
1699258319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 538
- Practice address
- 2835 Camino del Rio S Ste 210
San Diego, CA 92108-3825 - Phone
- (919) 389-0354
- NPI assigned
- Sep 9, 2018
- Last updated
- Sep 9, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 538 | CA | Primary |
Addresses
Primary practice location
2835 Camino del Rio S Ste 210
San Diego, CA 92108-3825
Mailing address
5721 Lake Murray Blvd Apt 18
La Mesa, CA 91942-1908
Phone (919) 389-0354
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1536451200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1536451200000",
"number": "1699258319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5721 LAKE MURRAY BLVD APT 18",
"city": "LA MESA",
"state": "CA",
"postal_code": "919421908",
"telephone_number": "919-389-0354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2835 CAMINO DEL RIO S STE 210",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921083825",
"telephone_number": "919-389-0354"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVERS",
"first_name": "MARLISSA",
"middle_name": "HINKLE",
"credential": "CPM, LM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-09-09",
"last_updated": "2018-09-09",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": "538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.