MISS MARY JEAN WALLIN (NPI# 1720084486) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720084486 |
| Entity Type | Individual |
| Full Name | MISS MARY JEAN WALLIN |
| Other Name | MARY J STUTSON |
| Credential | CERTIFIED NURSE MIDW |
| Practice Address |
1500 W 22nd St Ste 301 Sanford Health Maternal Fetal Medicine Clinic Sioux Falls SD 57105-1503 |
| Mailing Address |
Po Box 5074 Sioux Falls SD 57117-5074 |
| Practice Telephone | 6053287700 |
| Practice Fax Number | 6053287775 |
| Mailing Telephone | 6053286585 |
| Mailing Fax Number | 6053286512 |
| Enumeration Date | 2005-06-27 |
| Last Update Date | 2018-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 176B00000X | Midwife | Other Service Providers | ||
| N | 367A00000X | Advanced Practice Midwife | 0023 | SD | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SD | 6540104 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639408503 | Mary J Wallin | Licensed Practical Nurse | 300 N Maple St, Effingham, IL 62401-2003 | 2009-12-23 |
| Street Address |
1500 W 22ND ST STE 301 SANFORD HEALTH MATERNAL FETAL MEDICINE CLINIC |
| City | SIOUX FALLS |
| State | SD |
| Zip Code | 57105-1503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700497336 | Abby Mae Walton | Advanced Practice Midwife | 1500 W 22nd St Ste 301, Sioux Falls, SD 57105-1503 | 2020-08-17 |
| 1710516968 | Mary Schreurs | Physician Assistant | 1500 W 22nd St Ste 301, Sioux Falls, SD 57105-1503 | 2020-04-08 |
| 1235697806 | Hannah Sammons | Advanced Practice Midwife | 1500 W 22nd St Ste 301, Sioux Falls, SD 57105-1503 | 2019-03-03 |
| 1851862544 | Courtney L Hubert | Physician Assistant | 1500 W 22nd St Ste 301, Sioux Falls, SD 57105-1503 | 2018-12-06 |
| 1841776424 | Stephanie Deck | Nurse Practitioner | 1500 W 22nd St Ste 301, Sioux Falls, SD 57105-1503 | 2018-07-17 |
| 1609386358 | Molly Ann Kuehl | Nurse Practitioner | 1500 W 22nd St Ste 301, Sioux Falls, SD 57105-1503 | 2017-10-09 |
| 1407207244 | Elizabeth Hultgren | Obstetrics & Gynecology | 1500 W 22nd St Ste 301, Sioux Falls, SD 57105-1503 | 2016-06-22 |
| 1013361716 | Elizabeth Miller | Obstetrics & Gynecology | 1500 W 22nd St Ste 301, Sioux Falls, SD 57105-1503 | 2016-04-19 |
| 1093188591 | Sarah Ashleigh Roe | Advanced Practice Midwife | 1500 W 22nd St Ste 301, Sioux Falls, SD 57105 | 2015-11-05 |
| 1447654306 | Ashley Taylor | Physician Assistant | 1500 W 22nd St Ste 301, Sioux Falls, SD 57105-1503 | 2014-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871117549 | Ashlesha Ravindra Bagwe | Student in an Organized Health Care Education/Training Program | Pediatrics Residency Program, 1305 W 18th St, Rt 6364, Sioux Falls, SD 57105 | 2020-05-29 |
| 1306494489 | Kelsey Elaine Kruse | Counselor | 3101 West 41st, Sioux Falls, SD 57105 | 2019-08-30 |
| 1902388341 | Sarah Tacke | Nurse Practitioner | 1301 West 18th Street, Sioux Falls, SD 57105 | 2018-09-02 |
| 1235624727 | Mahum Shahid | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St, Sioux Falls, SD 57105 | 2018-06-27 |
| 1942790126 | Smitha Narayana Gowda | Student in an Organized Health Care Education/Training Program | 1400 22nd Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1326538554 | Mali Elizabeth Teller | Speech-Language Pathologist | 2501 W. 26th Street, Sioux Falls, SD 57105 | 2018-05-14 |
| 1871081505 | Abdelmohaymin Abdalla Abufatima Abdalla | Student in an Organized Health Care Education/Training Program | Usd-ssom-internal Medicine Residency, 1400 22nd Street, Sioux Falls, SD 57105 | 2018-04-27 |
| 1710474697 | Moataz Ellithi | Student in an Organized Health Care Education/Training Program | 1400 W. 22nd St., Sioux Falls, SD 57105 | 2018-04-17 |
| 1366948663 | Holly Ahlers | Registered Nurse | 2000 S. Summit Ave, Sioux Falls, Sd 57105, Sioux Falls, SD 57105 | 2018-04-04 |
| 1558864124 | Darcy Lee Jensen | Counselor | 822 East 41st. Street, Suite 235, Souix Falls, SD 57105 | 2018-03-09 |
| Find all providers in zip 57105 | ||||
| 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 |
|---|---|---|---|---|
| 1427321496 | Audra Joy Degroot | Midwife | 1417 S. Cliff Ave., Ste. 401, Sioux Falls, SD 57105-1064 | 2012-02-21 |
| 1144226895 | Vickie L Reiff | Midwife | 1500 W 22nd St, Ste 301, Sioux Falls, SD 57105-1503 | 2005-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780810895 | Sarah Anne Coulter Danner | Midwife | 640 Flormann St., Suite 400, Rapid City, SD 57701 | 2009-06-03 |
| 1902813652 | Mary Elizabeth Nielsen | Midwife | 619 Mountain View Rd, Rapid City, SD 57702-2518 | 2006-08-02 |
| 1609422690 | Tammi Jean Chaney | Midwife | 500 E 7th St, Platte, SD 57369-2115 | 2019-08-15 |
| 1720095474 | Jan C Mangelsen | Midwife | 640 Flormann St, Suite 400, Rapid City, SD 57701 | 2006-08-02 |
| 1053309740 | Sandra Kay Goodman | Midwife | 640 Flormann St, Rapid City, SD 57701-4679 | 2005-10-07 |
| City | SIOUX FALLS |
| Zip Code | 57105 |
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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.