Carolyn McDonald, CNM

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

4704207956 Issued in MI

Practice address

58887 Bremen Hwy
Mishawaka, IN 46544-6414

Phone

(574) 255-6182

Fax

(574) 255-6376

NPI assigned

Mar 30, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Midwife

State licenses

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1902926041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58887 BREMEN HWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465446414",
            "telephone_number": "574-255-6182",
            "fax_number": "574-255-6376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58887 BREMEN HWY",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465446414",
            "telephone_number": "574-255-6182",
            "fax_number": "574-255-6376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "CAROLYN",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28130755A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704207956",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IN",
            "license": "09000046A",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704207956",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM ID NUMBER",
            "identifier": "000000277513",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• McKinley Family Dental

• Registered Nurse in Mishawaka, IN
• Providers in Mishawaka, IN by specialty
• Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.