Kirsten Gwynn, CNM

Primary specialty

Advanced Practice MidwifeTaxonomy code 367A00000X

License

201405814NP-PP Issued in OR

Practice address

24850 SE Stark St Ste 200
Gresham, OR 97030-8320

Phone

(503) 491-9444

Fax

(503) 661-3430

NPI assigned

Jun 3, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Legacy Clinics LLCGroup PAC ID 0244144004, 714 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.62 of 100Reported as apm

Quality

77.21

Promoting interoperability

99.06

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kgwynn101836@direct.lhs.org

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.

• Legacy Clinics LLC

  • Clinic/Center
  • Portland, OR
  • NPI 1902827272
  Medicare reassignment Care Compare group NPD
• Legacy Mount Hood Medical Center

  • General Acute Care Hospital
  • Gresham, OR
  • NPI 1255354700
  NPD (past)

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

{
    "created_epoch": "1370217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1982041703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3777",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083777",
            "telephone_number": "503-413-3900",
            "fax_number": "503-413-3710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24850 SE STARK ST STE 200",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970308320",
            "telephone_number": "503-491-9444",
            "fax_number": "503-661-3430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 W Baltimore Pike",
            "address_2": "Suite 208",
            "address_purpose": "LOCATION",
            "city": "West Grove",
            "state": "PA",
            "postal_code": "193909446",
            "country_code": "US",
            "telephone_number": "610-869-2220",
            "fax_number": "610-869-6550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GWYNN",
        "first_name": "KIRSTEN",
        "name_prefix": "Ms.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-03",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "PA",
            "license": "MW010305",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "OR",
            "license": "201405814NP-PP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE-MIDWIFE LICENSE",
            "identifier": "MW010305",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julia Gunderson, LMT
• Yelisey Gurzhuy, DMD
• Gail Susan Gustafson, LMT
• Roberto Gutierrez
• Felicia Gwyn, CAE, LE
• Peter R Gyerko, MD
• Joseph Haas
• Timothy Hadden
• Cherie Hadley
• Craig Steven Haggett, MSN, FNP

• Advanced Practice Midwife in Gresham, OR
• Providers in Gresham, OR by specialty
• Advanced Practice Midwife in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.