Active NPI
Jamie Lynn Huberty-Koerner, CPM, LM
- Midwife
- Minneapolis, MN
National Provider Identifier
1912609553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- 1099
- Practice address
- 3033 Excelsior Blvd Ste 585
Minneapolis, MN 55416-6400 - Phone
- (612) 345-5920
- NPI assigned
- Mar 20, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Midwife | 176B00000X | 523-49 | WI | |
| Midwife | 176B00000X | 1099 | MN | Primary |
Addresses
Primary practice location
3033 Excelsior Blvd Ste 585
Minneapolis, MN 55416-6400
Mailing address
1043 Humboldt Ave
West Saint Paul, MN 55118-1432
Other practice location 1
149 Thompson Ave E Ste 215
West St Paul, MN 55118-3238
Phone (312) 350-1675
Other practice location 2
1043 Humboldt Ave
West Saint Paul, MN 55118-1432
Phone (312) 350-1675
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CPM23060259 | Other | NORTH AMERICAN REGISTRY OF MIDWIVES (NARM) |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1099 | MN | MD | Clinical Social Worker |
| 523-49 | WI | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709596800000",
"number": "1912609553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1043 HUMBOLDT AVE",
"city": "WEST SAINT PAUL",
"state": "MN",
"postal_code": "551181432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3033 EXCELSIOR BLVD STE 585",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554166400",
"telephone_number": "612-345-5920"
}
],
"practiceLocations": [
{
"address_1": "149 Thompson Ave E Ste 215",
"address_purpose": "LOCATION",
"city": "West St Paul",
"state": "MN",
"postal_code": "551183238",
"country_code": "US",
"telephone_number": "312-350-1675",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1043 Humboldt Ave",
"address_purpose": "LOCATION",
"city": "West Saint Paul",
"state": "MN",
"postal_code": "551181432",
"country_code": "US",
"telephone_number": "312-350-1675",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HUBERTY-KOERNER",
"first_name": "JAMIE",
"middle_name": "LYNN",
"credential": "CPM, LM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-20",
"last_updated": "2024-03-05",
"certification_date": "2024-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "WI",
"license": "523-49",
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "MN",
"license": "1099",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NORTH AMERICAN REGISTRY OF MIDWIVES (NARM)",
"identifier": "CPM23060259",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.