Individual provider Active NPI

Rose Waters, CNM

  • Advanced Practice Midwife
  • Davis, CA
National Provider Identifier
1801163589
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
1962 Issued in CA
Practice address
2051 John Jones Rd
Davis, CA 95616-9701
Phone
(530) 758-2060
NPI assigned
Nov 22, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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 1962 CA Primary

Addresses

Primary practice location

2051 John Jones Rd
Davis, CA 95616-9701

Mailing address

2051 John Jones Rd
Davis, CA 95616-9701
Phone (530) 758-2060

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
I20190621000255 CA Practitioner - Certified Nurse Midwife (CNM) 3870827058 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1962CAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ole Health CurrentSince Apr 13, 2019 Accepting new patients
Ole Health CurrentSince Apr 13, 2019 Accepting new patients

Locations

2051 John Jones Rd
Davis, CA 95616
Phone (530) 753-3498

215 W Beamer St
Woodland, CA 95695
Phone (530) 405-2800

Interoperability endpoints

  • Direct secure messaging: rwaters237682@hpmg.direct-ci.net

Organizations & group practices 2

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": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1801163589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2051 JOHN JONES RD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956169701",
            "telephone_number": "530-758-2060",
            "fax_number": "530-758-8490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2051 JOHN JONES RD",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "956169701",
            "telephone_number": "530-758-2060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERS",
        "first_name": "ROSE",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-22",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1962",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.