Individual provider Active NPI

Vivian Masters, CNM

  • Advanced Practice Midwife
  • Marietta, GA
National Provider Identifier
1972593036
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN065887 Issued in GA
Practice address
699 Church St NE
Suite 500
Marietta, GA 30060-1110
Phone
(770) 793-9750
Fax
(770) 919-0581
NPI assigned
Oct 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN065887 GA Primary

Addresses

Primary practice location

699 Church St NE
Suite 500
Marietta, GA 30060-1110

Mailing address

699 Church St NE
Suite 500
Marietta, GA 30060-1110
Phone (770) 793-9750

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20080428000125 GA Practitioner - Certified Nurse Midwife (CNM) 0143308494

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
RN065887GAMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: vmasters5625@directwellstar.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458518400000",
    "number": "1972593036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 CHURCH ST NE",
            "address_2": "SUITE 500",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601110",
            "telephone_number": "770-793-9750",
            "fax_number": "770-919-0581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 CHURCH ST NE",
            "address_2": "SUITE 500",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601110",
            "telephone_number": "770-793-9750",
            "fax_number": "770-919-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASTERS",
        "first_name": "VIVIAN",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2016-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "GA",
            "license": "RN065887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.