Active NPI
Judi Carol Davidson, CDM, CPM
- Lay Midwife
- Wasilla, AK
National Provider Identifier
1962625855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lay Midwife
- License
- AA10
- Practice address
- 2650 Broadview Ave
Wasilla, AK 99654-8302 - Phone
- (907) 373-3420
- Fax
- (907) 376-7847
- NPI assigned
- Apr 10, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lay Midwife | 175M00000X | AA10 | AK | Primary |
Addresses
Primary practice location
2650 Broadview Ave
Wasilla, AK 99654-8302
Mailing address
2650 Broadview Ave
Wasilla, AK 99654-8302
Phone (907) 373-3420
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NM0010 | Medicaid | AK | |
| AA10 | Other | AK | STATE LICENSE NUMBER |
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 |
|---|---|---|---|
| AA10 | AK | MD | Lay Midwife |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mat-Su Midwifery Inc | Current | Accepting new patients |
Locations
2650 E Broadview Ave
Wasilla, AK 99654
Phone (907) 373-3420
Organizations & group practices 1
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.
-
- Midwife
- Wasilla, AK
- NPI 1275696486
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962625855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2650 BROADVIEW AVE",
"city": "WASILLA",
"state": "AK",
"postal_code": "996548302",
"telephone_number": "907-373-3420",
"fax_number": "907-376-7847"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2650 BROADVIEW AVE",
"city": "WASILLA",
"state": "AK",
"postal_code": "996548302",
"telephone_number": "907-373-3420",
"fax_number": "907-376-7847"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIDSON",
"first_name": "JUDI",
"middle_name": "CAROL",
"name_prefix": "Mrs.",
"credential": "CDM, CPM",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "175M00000X",
"taxonomy_group": "",
"desc": "Midwife, Lay",
"state": "AK",
"license": "AA10",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NM0010",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "AA10",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wasilla, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.