Individual provider Active NPI

Emily Diane Dove-Medows, RN, CNM

  • Advanced Practice Midwife
  • Southfield, MI
National Provider Identifier
1790044246
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
4704270742 Issued in MI
Practice address
22255 Greenfield Rd Ste 352
Southfield, MI 48075-3712
Phone
(248) 849-3401
Fax
(248) 849-4106
NPI assigned
May 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 4704270742 MI Primary

Addresses

Primary practice location

22255 Greenfield Rd Ste 352
Southfield, MI 48075-3712

Mailing address

22255 Greenfield Rd Ste 352
Southfield, MI 48075-3712
Phone (248) 849-3401

Other practice location 1

3601 W 13 Mile Rd
Royal Oak, MI 48073-6712
Phone (248) 898-0898

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, Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704270742MIMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790044246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22255 GREENFIELD RD STE 352",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753712",
            "telephone_number": "248-849-3401",
            "fax_number": "248-849-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22255 GREENFIELD RD STE 352",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753712",
            "telephone_number": "248-849-3401",
            "fax_number": "248-849-4106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3601 W 13 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Royal Oak",
            "state": "MI",
            "postal_code": "480736712",
            "country_code": "US",
            "telephone_number": "248-898-0898",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOVE-MEDOWS",
        "first_name": "EMILY",
        "middle_name": "DIANE",
        "credential": "RN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704270742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.