Mary Jean Wallin, CERTIFIED NURSE MIDW

Primary specialty

MidwifeTaxonomy code 176B00000X

Practice address

1500 W 22ND St Ste 301
Sanford Health Maternal Fetal Medicine Clinic
Sioux Falls, SD 57105-1503

Phone

(605) 328-7700

Fax

(605) 328-7775

NPI assigned

Jun 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Mary J Stutson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1720084486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5074",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571175074",
            "telephone_number": "605-328-6585",
            "fax_number": "605-328-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 W 22ND ST STE 301",
            "address_2": "SANFORD HEALTH MATERNAL FETAL MEDICINE CLINIC",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051503",
            "telephone_number": "605-328-7700",
            "fax_number": "605-328-7775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "MARY",
        "middle_name": "JEAN",
        "name_prefix": "Miss",
        "credential": "CERTIFIED NURSE MIDW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-27",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "SD",
            "license": "0023",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6540104",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "STUTSON",
            "middle_name": "J",
            "credential": "CNM",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Megan Wallenberg
• Hope A Wallenstein, RN
• Jennifer Anne Waller, APRN-CNP
• Brian Leroy Wallin
• Douglas Dean Wallin, OD
• Samantha Wallner, MA
• Walmart Inc.
• Walmart Inc.
• Walmart Inc.
• Walmart Inc.

• Midwife in Sioux Falls, SD
• Providers in Sioux Falls, SD by specialty
• Midwife in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.

Verify at the official NPI Registry.