Individual provider Active NPI

Wendy H Raso, CNM

  • Advanced Practice Midwife
  • Pueblo, CO
National Provider Identifier
1700821469
Registry record updated Jan 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
71445 Issued in CO
Practice address
300 Colorado Ave
Pueblo, CO 81004-2006
Phone
(719) 543-8711
Fax
(719) 543-5340
NPI assigned
Jun 18, 2006
Last updated
Jan 7, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 71445 CO Primary

Addresses

Primary practice location

300 Colorado Ave
Pueblo, CO 81004-2006

Mailing address

110 E Routt Ave
Pueblo, CO 81004-2117
Phone (719) 543-8711

Other identifiers 2

IdentifierTypeStateIssuer
316335YLQPOtherCOMEDICARE PTAN
15456072MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131031000458 CO Practitioner - Certified Nurse Midwife (CNM) 5597990481 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo Community Health Center Inc CurrentSince Jul 10, 2013 Accepting new patients
Pueblo Community Health Center Inc CurrentSince Jul 10, 2013 Accepting new patients

Locations

110 E Routt Ave
Pueblo, CO 81004
Phone (719) 543-8718

300 Colorado Ave
Pueblo, CO 81004
Phone (719) 543-8718

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1150588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389052800000",
    "number": "1700821469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E ROUTT AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042117",
            "telephone_number": "719-543-8711",
            "fax_number": "719-543-5340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042006",
            "telephone_number": "719-543-8711",
            "fax_number": "719-543-5340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RASO",
        "first_name": "WENDY",
        "middle_name": "H",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-18",
        "last_updated": "2014-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CO",
            "license": "71445",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "316335YLQP",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15456072",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.