AUDRIE KINGZETT (NPI# 1417346511) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417346511 |
| Entity Type | Individual |
| Full Name | AUDRIE KINGZETT |
| Credential | CPM, LDEM |
| Practice Address |
400 Crater Lake Ave Medford OR 97504-6808 |
| Mailing Address |
3000 Delta Waters Rd Medford OR 97504-5840 |
| Practice Telephone | 5417722291 |
| Practice Fax Number | 5412450417 |
| Mailing Telephone | 5412613950 |
| Mailing Fax Number | 5412450417 |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-01-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 176B00000X | Midwife | DEM-LD10166074 | OR | Other Service Providers |
| Street Address |
400 CRATER LAKE AVE |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-6808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396898441 | Johanna Lydia Buck | Physical Therapist | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2007-01-20 |
| 1346876257 | Kelly Marie Barlow | Registered Nurse | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2020-03-23 |
| 1568971315 | Rebecca Meador | Occupational Therapist | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2017-09-25 |
| 1821526914 | Sound Music Therapy, LLC. | Music Therapist | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2017-06-01 |
| 1689105454 | Yvette Provosty | Physical Therapist | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2017-03-23 |
| 1467995084 | Neurotherapeutic Pediatric Therapies, Inc | Physical Therapist | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2016-11-30 |
| 1285060517 | Heather Chalmers Faith | Midwife | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2013-09-18 |
| 1073950036 | Aimee A Disharoon | Midwife | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2013-05-31 |
| 1659629137 | Wise Women Care Associates | Midwife, Lay | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2012-08-15 |
| 1891055034 | Brenda Marie Walleman | Music Therapist | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2012-05-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 176B00000X |
| Grouping | Other Service Providers |
| Classification | Midwife |
| A Midwife is a trained professional with special expertise in supporting women to maintain a healthy pregnancy birth, offering expert individualized care, education, counseling, and support to a woman and her newborn throughout the childbearing cycle. A Midwife is a skilled and independent practitioner who has undergone formalized training. Midwives are not required to be nurses and may be trained via multiple routes of education (apprenticeship, workshop, formal classes, or programs, etc., usually a combination). The educational background requirements and licensing requirements vary by state. The Midwife may or may not be certified by a state or national organization. |
| Notes: Source: The National Uniform Claim Committee [7/1/2007: title changed, definition changed, source changed] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508296971 | Kalista Birth Sanctuary LLC | Midwife | 924 E Jackson St, Medford, OR 97504 | 2013-11-20 |
| 1811336555 | Karen Pierce | Midwife | 811 W Broadway Ave Ste A, Medford, WI 54451-1307 | 2013-06-16 |
| 1285060517 | Heather Chalmers Faith | Midwife | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2013-09-18 |
| 1073950036 | Aimee A Disharoon | Midwife | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2013-05-31 |
| 1407124936 | Wise Women Care Associates, LLC | Midwife | 400 Crater Lake Ave, Medford, OR 97504-6808 | 2011-12-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730794306 | Capri Parker | Midwife | 815 Se 223rd Ave Apt 1, Gresham, OR 97030-2540 | 2020-09-10 |
| 1710590377 | Britney Frank | Midwife | 333 Warner Milne Rd Ste C, Oregon City, OR 97045-4123 | 2020-08-24 |
| 1023629185 | Bethany Joy Loehrke | Midwife | 314 Se Beech Ave, Gresham, OR 97080-7723 | 2020-08-12 |
| 1174133664 | Alysa Kristine Merritt | Midwife | 449 N 1st St, Aumsville, OR 97325-9601 | 2020-08-09 |
| 1376185538 | Wilder Midwifery, LLC | Midwife | 405 Ne 3rd St, Mcminnville, OR 97128-6219 | 2019-10-09 |
| 1477194546 | Whitney Wolfe | Midwife | 3604 Nw Marcotte Rd, Portland, OR 97229-2545 | 2019-09-30 |
| 1851942510 | Holly Scholles | Midwife | 4997 Sw Normandy Pl, Beaverton, OR 97005-3635 | 2019-09-24 |
| 1942859137 | Caley Brown | Midwife | 4711 Ne 60th Ave, Portland, OR 97218-2610 | 2019-09-10 |
| 1386204311 | Hannah Joy Swan | Midwife | 761 Sw Washington St, Dallas, OR 97338-3413 | 2019-06-20 |
| 1619534237 | Caitlin K Maddigan | Midwife | 4057 N Concord Ave, Portland, OR 97227-1013 | 2019-05-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.