Individual provider Active NPI

Ingrid M. Gold, CNM

  • Advanced Practice Midwife
  • Phoenix, AZ
National Provider Identifier
1801894092
Registry record updated Mar 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP0220 Issued in AZ
Practice address
10240 W Indian School Rd
Building 2 Suite# 140
Phoenix, AZ 85037-5904
Phone
(623) 846-7558
Fax
(623) 846-1674
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2016

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 092976 AZ
Advanced Practice Midwife 367A00000X AP0220 AZ Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X RN092976 AZ
Advanced Practice Midwife 367A00000X RN092976 AZ

Addresses

Primary practice location

10240 W Indian School Rd
Building 2 Suite# 140
Phoenix, AZ 85037-5904

Mailing address

10240 W Indian School Rd
Building 2 Suite# 140
Phoenix, AZ 85037-5904
Phone (623) 846-7558

Other identifiers 1

IdentifierTypeStateIssuer
393695MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20050803001059 AZ Practitioner - Certified Nurse Midwife (CNM) 3375571938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arizona OB GYN Affiliates PCGroup PAC ID 7911094040, 122 clinicians

Practice addresses (Care Compare)

1950 W Frye Rd
Suite B
Chandler, AZ 85224-6255
Phone (480) 895-9555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN092976AZMDObstetrics & Gynecology Nurse Practitioner
092976AZMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Arizona OB GYN Affiliates PC CurrentSince Jul 24, 2019 Accepting new patients
Arizona OB/GYN Affiliates PC Past Accepting new patients

Locations

1950 W Frye Rd
Ste B
Chandler, AZ 85224

1757 E Melrose St
Gilbert, AZ 85297

1170 N Estrella Pkwy
Ste A107
Goodyear, AZ 85338
Phone (623) 263-0105

35 N Estrella Pkwy
Goodyear, AZ 85338
Phone (623) 846-7558

1661 E Camelback Rd
Ste 160
Phoenix, AZ 85016
Phone (602) 241-1671

9930 W Indian School Rd
Phoenix, AZ 85037
Phone (623) 846-7558

10240 W Indian School Rd
Ste 140
Phoenix, AZ 85037
Phone (623) 846-7558

530 E Thomas Rd
Phoenix, AZ 85012
Phone (602) 351-2229

1840 E Baseline Rd
Ste A3
Tempe, AZ 85283
Phone (480) 618-1342

Interoperability endpoints

  • Direct secure messaging: ingrid.gold.1@14294.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/14294/brand/1/csg/1/fhir/r4

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, 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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458691200000",
    "number": "1801894092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10240 W INDIAN SCHOOL RD",
            "address_2": "BUILDING 2 SUITE# 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375904",
            "telephone_number": "623-846-7558",
            "fax_number": "623-846-1674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10240 W INDIAN SCHOOL RD",
            "address_2": "BUILDING 2 SUITE# 140",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850375904",
            "telephone_number": "623-846-7558",
            "fax_number": "623-846-1674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "INGRID",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2016-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "092976",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "AP0220",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "AZ",
            "license": "RN092976",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "RN092976",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "393695",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.