Susan Wolcott, LM, CPM, RN

Primary specialty

MidwifeTaxonomy code 176B00000X

License

166 Issued in CA

Practice address

703 S a St
Mount Shasta, CA 96067

Phone

(562) 334-5706

Fax

(626) 610-3825

NPI assigned

Jul 9, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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

• Shasta Midwives Birth Center Inc

  • Birthing Clinic/Center
  • Mount Shasta, CA
  • NPI 1194170621
  NPD (past) Authorized official

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1952334278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5105 PLUM AVE",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "960679155",
            "telephone_number": "530-926-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 S A ST",
            "city": "MOUNT SHASTA",
            "state": "CA",
            "postal_code": "96067",
            "telephone_number": "562-334-5706",
            "fax_number": "626-610-3825"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "983 Mission De Oro Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "960033850",
            "country_code": "US",
            "telephone_number": "530-918-5746",
            "fax_number": "626-604-5233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLCOTT",
        "first_name": "SUSAN",
        "credential": "LM, CPM, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-09",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP1700X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Perinatal",
            "state": "CA",
            "license": "619799",
            "primary": false
        },
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "CA",
            "license": "166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul G. Wertzberger, LCSW., PSY.D.
• Western Physical Therapy, Inc.
• Marianne Wilson
• Alyssa Winkelman
• Carol Winston, PT
• Benjamin Joseph Worrell
• Stephanie Yarger, LMFT
• Erich Ziller
• Philip Zimmerman, CRNA

• Midwife in Mount Shasta, CA
• Providers in Mount Shasta, CA by specialty
• Midwife in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.