Individual provider Active NPI

Edith C Kramer, CNM

  • Advanced Practice Midwife
  • Roseburg, OR
National Provider Identifier
1861435455
Registry record updated Feb 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
099006554N5 Issued in OR
Practice address
2460 NW Stewart Pkwy
Suite 240
Roseburg, OR 97471-1516
Phone
(541) 677-4427
Fax
(541) 677-6522
NPI assigned
Jun 13, 2006
Last updated
Feb 23, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X 099006554N5 OR
Advanced Practice Midwife 367A00000X 099006554N5 OR Primary

Addresses

Primary practice location

2460 NW Stewart Pkwy
Suite 240
Roseburg, OR 97471-1516

Mailing address

PO Box 568
Winchester, OR 97495-0568
Phone (541) 677-4427

Other identifiers 1

IdentifierTypeStateIssuer
210768MedicaidOR

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)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
099006554N5ORMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266883200000",
    "number": "1861435455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "WINCHESTER",
            "state": "OR",
            "postal_code": "974950568",
            "telephone_number": "541-677-4427",
            "fax_number": "541-677-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 NW STEWART PKWY",
            "address_2": "SUITE 240",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974711516",
            "telephone_number": "541-677-4427",
            "fax_number": "541-677-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRAMER",
        "first_name": "EDITH",
        "middle_name": "C",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2010-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "OR",
            "license": "099006554N5",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "099006554N5",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "210768",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseburg, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2010; 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.