Nicole Kindness Mortensen, CNM, WHNP

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

AP9562 Issued in AZ

Practice address

2020 W 16TH St
Safford, AZ 85546-4026

Phone

(928) 424-4444

NPI assigned

Oct 19, 2016

Sex

Female

Sole proprietor

No

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

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Certified Nurse Midwife (CNM)

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mt Graham Regional Medical Center IncGroup PAC ID 6204822364, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

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.

• Mt Graham Regional Medical Center Inc

  • Critical Access Hospital
  • Safford, AZ
  • NPI 1275588345
  Medicare reassignment Care Compare group NPD
• Mt Graham Regional Medical Center Inc

  • Rural Health Clinic/Center
  • Safford, AZ
  • NPI 1346528759
  NPD (past)

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

{
    "created_epoch": "1476835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480550400000",
    "number": "1962953497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W 16TH ST",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464026",
            "telephone_number": "928-424-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W 16TH ST",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855464026",
            "telephone_number": "928-424-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "NICOLE",
        "middle_name": "KINDNESS",
        "credential": "CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-19",
        "last_updated": "2016-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AZ",
            "license": "AP9568",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "AZ",
            "license": "AP9562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Miller
• Shayleh Moffett, WHNP
• Bradford N. Montierth, M.D
• Jeanette Marcroft Montierth, LAC
• Tracy Jon Montierth, O.D.
• Karen Lynn Moskal
• Mount Graham Dental Associates PLC
• Mount Graham Family Medicine Practice,P.C.
• Mountain View Anesthesia, PC
• Mountain View Counseling

• Advanced Practice Midwife in Safford, AZ
• Providers in Safford, AZ by specialty
• Advanced Practice Midwife in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.