Individual provider Active NPI

Laura Mahony, CNM

  • Advanced Practice Midwife
  • Scott Depot, WV
National Provider Identifier
1740269844
Registry record updated Apr 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
034 Issued in WV
Practice address
301-6 Great Teays Blvd
Scott Depot, WV 25560
Phone
(304) 757-6999
Fax
(304) 757-3252
NPI assigned
Jan 17, 2006
Last updated
Apr 20, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 20, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 034 WV Primary
Registered Nurse 163W00000X 33777 WV

Addresses

Primary practice location

301-6 Great Teays Blvd
Scott Depot, WV 25560

Mailing address

301-6 Great Teays Blvd
Scott Depot, WV 25560
Phone (304) 757-6999

Other identifiers 3

IdentifierTypeStateIssuer
0160021000MedicaidWV
001721061OtherWVMS BCBS
7972174OtherWVAETNA

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

State licenses

LicenseStateTypeSpecialty
034WVMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1137456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1740269844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301-6 GREAT TEAYS BLVD",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "25560",
            "telephone_number": "304-757-6999",
            "fax_number": "304-757-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301-6 GREAT TEAYS BLVD",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "25560",
            "telephone_number": "304-757-6999",
            "fax_number": "304-757-3252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONY",
        "first_name": "LAURA",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-17",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WV",
            "license": "034",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "33777",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160021000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS BCBS",
            "identifier": "001721061",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7972174",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scott Depot, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; 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.