Active NPI
Marimikel Potter, RN-BSN, LM, CPM
- Midwife
- Austin, TX
National Provider Identifier
1831301407
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 96080
- Practice address
- 9302 Castlewood Dr
Austin, TX 78748-6010 - Phone
- (512) 477-5452
- Fax
- (512) 477-5616
- NPI assigned
- May 4, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 96080 | TX | Primary |
Addresses
Primary practice location
9302 Castlewood Dr
Austin, TX 78748-6010
Mailing address
9302 Castlewood Dr
Austin, TX 78748-6010
Phone (512) 477-5452
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 742112060 | Other | TX | TAX IDENTIFICATION NUMBER |
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 |
|---|---|---|---|
| 96080 | TX | MD | Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Life Birth Services, Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
dba New Life Birth Center
- High-Risk Obstetric Registered Nurse
- Austin, TX
- NPI 1831301415
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428451200000",
"number": "1831301407",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9302 CASTLEWOOD DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787486010",
"telephone_number": "512-477-5452",
"fax_number": "512-477-5616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9302 CASTLEWOOD DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787486010",
"telephone_number": "512-477-5452",
"fax_number": "512-477-5616"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTTER",
"first_name": "MARIMIKEL",
"name_prefix": "Ms.",
"credential": "RN-BSN, LM, CPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-04",
"last_updated": "2015-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "TX",
"license": "96080",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATION NUMBER",
"identifier": "742112060",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.