Individual provider Active NPI

Annie Grace Siroky, LM, CPM

  • Midwife
  • Ventura, CA
National Provider Identifier
1750164810
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
LM721 Issued in CA
Practice address
3458 Loma Vista Rd
Ventura, CA 93003-3026
Phone
(805) 667-2229
Fax
(805) 852-2635
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X LM721 CA Primary

Addresses

Primary practice location

3458 Loma Vista Rd
Ventura, CA 93003-3026

Mailing address

3458 Loma Vista Rd
Ventura, CA 93003-3026
Phone (805) 667-2229

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

State licenses

LicenseStateTypeSpecialty
LM721CAMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Ventura Birth Center CurrentSince Aug 27, 2023 Accepting new patients

Locations

3458 Loma Vista Rd
Ventura, CA 93003
Phone (805) 290-6210

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": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1750164810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3458 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033026",
            "telephone_number": "805-667-2229",
            "fax_number": "805-852-2635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3458 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033026",
            "telephone_number": "805-667-2229",
            "fax_number": "805-852-2635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIROKY",
        "first_name": "ANNIE",
        "middle_name": "GRACE",
        "credential": "LM, CPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "LM721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ventura, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.