Individual provider Active NPI

Christina Booth Edelman, CNM, WHNP

  • Advanced Practice Midwife
  • San Diego, CA
National Provider Identifier
1922070044
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
1996 Issued in CA
Practice address
34800 Bob Wilson Dr Naval Medical Center San Diego
San Diego, CA 92134-0001
Phone
(619) 532-7082
Fax
(619) 532-6587
NPI assigned
Feb 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X NP 15499 CA
Women's Health Nurse Practitioner 363LW0102X 26NJ0061300 NJ
Advanced Practice Midwife 367A00000X 25ME00060800 NJ
Advanced Practice Midwife 367A00000X 1996 CA Primary

Addresses

Primary practice location

34800 Bob Wilson Dr Naval Medical Center San Diego
San Diego, CA 92134-0001

Mailing address

955 Harbor View Dr
San Diego, CA 92106-2437
Phone (619) 518-0756

Other identifiers 9

IdentifierTypeStateIssuer
645813OtherCARN CA
RN 645813OtherCARN LICENSE
25ME00060801OtherNJCNM W/PRESCRIPTIVE AUTHORITY
NP 15499OtherCANP LICENSE
1996OtherCACNM LICENSE
26NJ0061300OtherNJADVANCED PRACTICE NURSE
26NR18421700OtherNJRN NJ
15499OtherCANP WITH FURNISHING
25ME00060800OtherNJCNM

Other names 1

  • Ms. Christina Gretchen Booth Former name

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
NP 15499CAMDWomen's Health Nurse Practitioner
26NJ0061300NJMDWomen's Health Nurse Practitioner
25ME00060800NJMDAdvanced Practice Midwife

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1922070044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 HARBOR VIEW DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921062437",
            "telephone_number": "619-518-0756",
            "fax_number": "619-524-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34800 BOB WILSON DR NAVAL MEDICAL CENTER SAN DIEGO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921340001",
            "telephone_number": "619-532-7082",
            "fax_number": "619-532-6587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDELMAN",
        "first_name": "CHRISTINA",
        "middle_name": "BOOTH",
        "name_prefix": "Ms.",
        "credential": "CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-02",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CA",
            "license": "NP 15499",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NJ",
            "license": "26NJ0061300",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NJ",
            "license": "25ME00060800",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CA",
            "license": "1996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN CA",
            "identifier": "645813",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "RN 645813",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNM W/PRESCRIPTIVE AUTHORITY",
            "identifier": "25ME00060801",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP LICENSE",
            "identifier": "NP 15499",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNM LICENSE",
            "identifier": "1996",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANCED PRACTICE NURSE",
            "identifier": "26NJ0061300",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN NJ",
            "identifier": "26NR18421700",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NP WITH FURNISHING",
            "identifier": "15499",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CNM",
            "identifier": "25ME00060800",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "BOOTH",
            "middle_name": "GRETCHEN",
            "prefix": "MS.",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.