Individual provider Active NPI

Anne W Wheatley, CNM

  • Advanced Practice Midwife
  • Tacoma, WA
National Provider Identifier
1790796472
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP30006588 Issued in WA
Practice address
1812 S J St
#120
Tacoma, WA 98405-4964
Phone
(253) 207-4890
Fax
(253) 207-4871
NPI assigned
Aug 10, 2006
Last updated
May 2, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2011

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 AP30006588 WA Primary

Addresses

Primary practice location

1812 S J St
#120
Tacoma, WA 98405-4964

Mailing address

1812 S J St
#120
Tacoma, WA 98405-4964
Phone (253) 207-4890

Other identifiers 3

IdentifierTypeStateIssuer
0176351OtherWASTATE L&I
8931117OtherWASTATE CRIME VICTIMS
9638628MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP30006588WAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
The Carol Milgard Breast Center CurrentSince May 3, 2023 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 110
Gig Harbor, WA 98335
Phone (253) 759-2622

4525 S 19th St
Tacoma, WA 98405
Phone (253) 759-2622

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, 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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304294400000",
    "number": "1790796472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1812 S J ST",
            "address_2": "#120",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054964",
            "telephone_number": "253-207-4890",
            "fax_number": "253-207-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1812 S J ST",
            "address_2": "#120",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054964",
            "telephone_number": "253-207-4890",
            "fax_number": "253-207-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEATLEY",
        "first_name": "ANNE",
        "middle_name": "W",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2011-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "WA",
            "license": "AP30006588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE L&I",
            "identifier": "0176351",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CRIME VICTIMS",
            "identifier": "8931117",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9638628",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.