Individual provider Active NPI

Mikala Trumbo, CNM

  • Advanced Practice Midwife
  • Grand Junction, CO
National Provider Identifier
1760092308
Registry record updated Oct 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
APN.0995313 Issued in CO
Practice address
2373 G Rd Ste 240
Grand Junction, CO 81505-1006
Phone
(970) 243-7908
Fax
(970) 245-0656
NPI assigned
Aug 7, 2020
Last updated
Oct 27, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X APN.0995313 CO
Advanced Practice Midwife 367A00000X APN.0995313 CO Primary

Addresses

Primary practice location

2373 G Rd Ste 240
Grand Junction, CO 81505-1006

Mailing address

PO Box 1727
Grand JCT, CO 81502-1727
Phone (970) 243-7908

Other names 1

  • Mikala Koster Former name

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
I20201102000022 CO Practitioner - Certified Nurse Midwife (CNM) 1850701988 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN.0995313COMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Group, LLC Current Accepting new patients
Community Medical Group, LLC CurrentSince Nov 1, 2020 Accepting new patients
Community Medical Group, LLC CurrentSince Nov 1, 2020 Accepting new patients
Community Medical Group Past Accepting new patients
Colorado West Healthcare System Past Accepting new patients

Locations

2373 G Rd
Ste 240
Grand Junction, CO 81505
Phone (970) 243-7908

688 23 12 Rd Ste 304
Ste 304
Grand Junction, CO 81505

2373 G Rd
Grand Junction, CO 81505
Phone (970) 243-3061

Organizations & group practices 5

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": "1596758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603756800000",
    "number": "1760092308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1727",
            "city": "GRAND JCT",
            "state": "CO",
            "postal_code": "815021727",
            "telephone_number": "970-243-7908",
            "fax_number": "970-245-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2373 G RD STE 240",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815051006",
            "telephone_number": "970-243-7908",
            "fax_number": "970-245-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUMBO",
        "first_name": "MIKALA",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-07",
        "last_updated": "2020-10-27",
        "certification_date": "2020-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CO",
            "license": "APN.0995313",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CO",
            "license": "APN.0995313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIKALA",
            "last_name": "KOSTER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.