Individual provider Active NPI

Willow Merchant, FNP, RN, IBCLC

  • Family Nurse Practitioner
  • Boulder Creek, CA
National Provider Identifier
1871952507
Registry record updated Feb 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16133 Issued in CA
Practice address
343 W Hilton Dr
Boulder Creek, CA 95006-9207
Phone
(650) 862-9336
Fax
(831) 703-4773
NPI assigned
Feb 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 545590 CA
Family Nurse Practitioner 363LF0000X 16133 CA Primary

Addresses

Primary practice location

343 W Hilton Dr
Boulder Creek, CA 95006-9207

Mailing address

343 W Hilton Dr
Boulder Creek, CA 95006-9207
Phone (650) 862-9336

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
545590CAMDLactation Consultant (Registered Nurse)
16133CAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1456185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456185600000",
    "number": "1871952507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 W HILTON DR",
            "city": "BOULDER CREEK",
            "state": "CA",
            "postal_code": "950069207",
            "telephone_number": "650-862-9336",
            "fax_number": "831-703-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 W HILTON DR",
            "city": "BOULDER CREEK",
            "state": "CA",
            "postal_code": "950069207",
            "telephone_number": "650-862-9336",
            "fax_number": "831-703-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERCHANT",
        "first_name": "WILLOW",
        "credential": "FNP, RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-23",
        "last_updated": "2016-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "545590",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "16133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder Creek, CA

Sources for this page

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

Verify at the official NPI Registry.