Active NPI
Misty Lee Adriaanse, C.P.M., L.M.
- Midwife
- Long Beach, CA
National Provider Identifier
1811259740
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 418
- Practice address
- 352 Hermosa Ave
Long Beach, CA 90802-3842 - Phone
- (520) 603-9197
- Fax
- (520) 333-3123
- NPI assigned
- Jun 15, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 170 | AZ | |
| Midwife | 176B00000X | 418 | CA | Primary |
Addresses
Primary practice location
352 Hermosa Ave
Long Beach, CA 90802-3842
Mailing address
352 Hermosa Ave
Long Beach, CA 90802-3842
Phone (520) 603-9197
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 418 | CA | MD | Midwife |
| 170 | AZ | MD | Adult Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472688000000",
"number": "1811259740",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "352 HERMOSA AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908023842",
"telephone_number": "520-603-9197",
"fax_number": "520-333-3123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "352 HERMOSA AVE",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908023842",
"telephone_number": "520-603-9197",
"fax_number": "520-333-3123"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ADRIAANSE",
"first_name": "MISTY",
"middle_name": "LEE",
"name_prefix": "Mrs.",
"credential": "C.P.M., L.M.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-15",
"last_updated": "2016-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "AZ",
"license": "170",
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": "418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.