NPIMap

Organization Active NPI

Blue Moon Midwifery LLC

  • Midwife
  • Saint Paul, MN
National Provider Identifier
1851797617
Registry record updated Nov 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
Legal business name
BLUE MOON MIDWIFERY LLC
Practice address
113 Wheelock Pkwy E
Saint Paul, MN 55117-3934
Phone
(715) 308-9540
NPI assigned
Nov 6, 2014
Last updated
Nov 6, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2014

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

Authorized official

Name
Ms. Jessica Elena Kirkwood Weaver, CPMNPI 1518222777
Title
Owner
Phone
(715) 308-9540

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X Primary

Addresses

Primary practice location

113 Wheelock Pkwy E
Saint Paul, MN 55117-3934

Mailing address

113 Wheelock Pkwy E
Saint Paul, MN 55117-3934
Phone (715) 308-9540

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415232000000",
    "number": "1851797617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 WHEELOCK PKWY E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551173934",
            "telephone_number": "715-308-9540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WHEELOCK PKWY E",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551173934",
            "telephone_number": "715-308-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE MOON MIDWIFERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-06",
        "last_updated": "2014-11-06",
        "status": "A",
        "authorized_official_last_name": "KIRKWOOD WEAVER",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "ELENA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "715-308-9540",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CPM"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.