Individual provider Active NPI

Maria Angela King, CNM, RN

  • Advanced Practice Midwife
  • San Bernardino, CA
National Provider Identifier
1801002704
Registry record updated Aug 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
1593 Issued in CA
Practice address
1881 Business Center Dr Ste 8a
San Bernardino, CA 92408-3448
Phone
(714) 470-1506
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2019

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse)Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WL0100X 615636 CA
Maternal Newborn Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WM0102X 1593 CA
Low-Risk Neonatal Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WN0003X 1593 CA
Perinatal Registered NurseGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 163WP1700X 1593 CA
Ambulatory Women's Health Care Registered Nurse 163WW0101X 1593 CA
Health EducatorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174H00000X
Diagnostic Ultrasound PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085U0001X 615636 CA
Advanced Practice Midwife 367A00000X 1593 CA Primary

Addresses

Primary practice location

1881 Business Center Dr Ste 8a
San Bernardino, CA 92408-3448

Mailing address

6240 Black Pearl CT
Mira Loma, CA 91752-4405
Phone (714) 470-1506

Other identifiers 1

IdentifierTypeStateIssuer
12646542OtherCACAQH PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20200305000916 CA Practitioner - Certified Nurse Midwife (CNM) 2668809500 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
615636CAMDLactation Consultant (Registered Nurse)
1593CAMDPerinatal Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The Natural Birth Place Inc Lactation Consultant CurrentSince Aug 18, 2019 Accepting new patients
Natural Birth Place Providers a Professional Nurse Midwifery Corp. Lactation Consultant CurrentSince Aug 18, 2019 Accepting new patients
Obhg California, P.C. Single Specialty CurrentSince Jan 21, 2020 Accepting new patients

Locations

25500 Medical Center Dr
Murrieta, CA 92562
Phone (951) 696-6000

39000 Bob Hope Dr
Rancho Mirage, CA 92270
Phone (760) 340-3911

1881 Business Center Dr
Ste 8A
San Bernardino, CA 92408
Phone (714) 470-1506

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 908-3736

Organizations & group practices 3

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565913600000",
    "number": "1801002704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6240 BLACK PEARL CT",
            "city": "MIRA LOMA",
            "state": "CA",
            "postal_code": "917524405",
            "telephone_number": "714-470-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 BUSINESS CENTER DR STE 8A",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083448",
            "telephone_number": "714-470-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "MARIA",
        "middle_name": "ANGELA",
        "name_prefix": "Mrs.",
        "credential": "CNM, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2019-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "615636",
            "primary": false
        },
        {
            "code": "163WM0102X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Maternal Newborn",
            "state": "CA",
            "license": "1593",
            "primary": false
        },
        {
            "code": "163WN0003X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Neonatal, Low-Risk",
            "state": "CA",
            "license": "1593",
            "primary": false
        },
        {
            "code": "163WP1700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Registered Nurse, Perinatal",
            "state": "CA",
            "license": "1593",
            "primary": false
        },
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "CA",
            "license": "1593",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "CA",
            "license": "615636",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "12646542",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

Verify at the official NPI Registry.