Individual provider Active NPI

Kaitlin Spangler, CNM

  • Advanced Practice Midwife
  • Pismo Beach, CA
National Provider Identifier
1881013076
Registry record updated May 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
235644 Issued in CA
Practice address
2 James Way Ste 106
Pismo Beach, CA 93449-4974
Phone
(805) 773-3060
Fax
(805) 269-0026
NPI assigned
Apr 15, 2014
Last updated
May 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 235644 CA Primary

Addresses

Primary practice location

2 James Way Ste 106
Pismo Beach, CA 93449-4974

Mailing address

2 James Way Ste 106
Pismo Beach, CA 93449-4974
Phone (805) 773-3060

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180829002867 CA Practitioner - Certified Nurse Midwife (CNM) 5890045678 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
235644CAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Permanente Medical Group, Inc CurrentSince Jul 7, 2018 Accepting new patients
Permanente Medical Group Inc Current Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 2, 2023 Accepting new patients
Permanente Medical Group Inc CurrentSince Jul 7, 2018 Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients

Locations

750 Auburn Ravine Rd
Auburn, CA 95603
Phone (530) 823-6131

4753 W Shaw Ave
Ste 101
Fresno, CA 93722
Phone (559) 277-8738

900 N Douty St
Hanford, CA 93230
Phone (559) 587-9014

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

101 Monroe St
Petaluma, CA 94954
Phone (707) 763-4109

1150 Veterans Blvd
Redwood City, CA 94063
Phone (650) 299-2015

901 Nevin Ave
Richmond, CA 94801
Phone (510) 307-1500

930 W Main St
Ripon, CA 95366
Phone (209) 599-4221

1650 Response Rd
Sacramento, CA 95815
Phone (916) 614-4040

4647 Zion Ave
San Diego, CA 92120
Phone (619) 528-3038

2200 Ofarrell St
San Francisco, CA 94115
Phone (415) 202-2000

710 Lawrence Expy
Santa Clara, CA 95051
Phone (408) 236-6400

5615 Scotts Valley Dr
Scotts Valley, CA 95066
Phone (831) 430-2700

7373 West Ln
Stockton, CA 95210
Phone (209) 476-2000

975 Sereno Dr
Vallejo, CA 94589
Phone (707) 651-1000

320 N Crawford St
Willows, CA 95988
Phone (530) 934-2834

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1881013076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY STE 106",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494974",
            "telephone_number": "805-773-3060",
            "fax_number": "805-269-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 JAMES WAY STE 106",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934494974",
            "telephone_number": "805-773-3060",
            "fax_number": "805-269-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANGLER",
        "first_name": "KAITLIN",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "235644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4647 Zion Ave",
            "city": "San Diego",
            "state": "CA",
            "country_code": "US",
            "postal_code": "921202507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pismo Beach, CA

Sources for this page

Verify at the official NPI Registry.