Active NPI
Nancy S Clark, CNM
- Midwife
- Las Cruces, NM
National Provider Identifier
1740440809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 4923
- Practice address
- 390 Calle de Alegra
Las Cruces, NM 88005-3280 - Phone
- (575) 556-8150
- Fax
- (505) 556-8159
- NPI assigned
- Jun 12, 2008
- 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 | 4923 | NM | Primary |
Addresses
Primary practice location
390 Calle de Alegra
Las Cruces, NM 88005-3280
Mailing address
390 Calle de Alegra
Las Cruces, NM 88006
Phone (575) 556-8150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 95147 | 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 291 | NM | MD | Acupuncturist |
| 4923 | NM | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| First Step Center | Midwife | Past | Accepting new patients |
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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213228800000",
"number": "1740440809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "390 CALLE DE ALEGRA",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "88006",
"telephone_number": "575-556-8150",
"fax_number": "575-556-8159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "390 CALLE DE ALEGRA",
"city": "LAS CRUCES",
"state": "NM",
"postal_code": "880053280",
"telephone_number": "575-556-8150",
"fax_number": "505-556-8159"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "NANCY",
"middle_name": "S",
"credential": "CNM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-12",
"last_updated": "2008-06-12",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "NM",
"license": "4923",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "95147",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Las Cruces, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.