PROVIDENCE ST. MARY MEDICAL CENTER
NPI 1043406440
Advanced Practice Midwife in Apple Valley, CA

Q: What is St. Mary Medical Center's NPI number?

The NPI number for St. Mary Medical Center is 1043406440. It was assigned to this organization in the NPPES registry on September 19, 2007. The provider is doing business as Providence St. Mary Medical Center.

Q: What is St. Mary Medical Center's specialty?

The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.

Active since September 19, 2007CLIA Certified · 3 labs

18077 US HIGHWAY 18, APPLE VALLEY, CA 92307(760) 946-8169(760) 946-8875 Get Directions Write a Review

NPPES record last updated: December 16, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Providence St. Mary Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PROVIDENCE ST. MARY MEDICAL CENTER (NPI 1043406440) is a healthcare organization registered as an advanced practice midwife in Apple Valley, California and active in the NPI registry since September 2007. The organization holds 3 active CLIA laboratory certificates and lists Randall Castillo, Chief Executive, as its authorized official.

NPPES Registry Identity

NPI1043406440

Entity TypeOrganization

Primary Taxonomy367A00000X

Legal Business NameST. MARY MEDICAL CENTER

Location Address18077 US HIGHWAY 18Apple Valley, CA 92307-2150

Mailing Address18300 Us Highway 18Apple Valley, CA 92307-2206 · (760) 242-2311

Phone(760) 946-8169

Fax(760) 946-8875

Organization SubpartNo

Authorized OfficialRandall CastilloChief Executive · (760) 946-8195

Enumeration DateSeptember 19, 2007

Last NPPES UpdateDecember 16, 2020

NPPES CertifiedDecember 16, 2020

✔ NPI 1043406440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAdvanced Practice MidwifePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367A00000X

License✔ Licensed in CA · NMW1225

Definition

Advanced practice midwifery encompasses the independent provision of care during pregnancy, childbirth, and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care. Midwives also provide primary care for individuals from adolescence throughout the lifespan as well as care for the healthy newborn during the first 28 days of life. Midwives provide initial and ongoing comprehensive assessment, diagnosis, and treatment. Midwifery care includes health promotion, disease prevention, risk assessment and management, and individualized wellness education and counseling. Source: American College of Nurse-Midwives, www.midwife.org Additional Resources: See the American College of Nurse-Midwives, www.midwife.org, for more information on Certified Nurse-Midwives, Certified Midwives, the American Midwifery Certification Board (AMCB), and licensure.

18077 US HIGHWAY 18, Apple Valley, CA 92307

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Other Names 1

Doing Business AsProvidence St. Mary Medical Center

Other Identifiers 1

OtherGNMW00060CA · Medical

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 3

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2008083

St Mary Medical Center Dba Providence St Mary Medical Center · Apple Valley, CA

Active · expires Jun 2, 2028

CLIA Number05D2008083

Laboratory TypeWound Care Clinic

Certificate Effective DateJune 3, 2026

Certificate Expiration DateJune 2, 2028

Laboratory DirectorBipinchandra Bhagat

Laboratory Phone(760) 242-2311

Laboratory LocationSt Mary Medical Center Dba Providence St Mary Medical Center16077 Kamana Rd, Ste A, Apple Valley, CA 92307

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D0935663

St Mary Medical Center Dba Providence St Mary Medical Center · Apple Valley, CA

Active · expires Dec 13, 2027

CLIA Number05D0935663

Laboratory TypeAmbulatory Surgery Center

Certificate Effective DateDecember 14, 2025

Certificate Expiration DateDecember 13, 2027

Laboratory DirectorJames B. Harris

Laboratory Phone(760) 946-8746

Laboratory LocationSt Mary Medical Center Dba Providence St Mary Medical Center18122 Highway 18, Apple Valley, CA 92307

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Certificate of Accreditation 05D0573048

St. Mary Medical Center Dba Providence St Mary Medical Center · Apple Valley, CA

Active · expires Jan 2, 2027

CLIA Number05D0573048

Laboratory TypeHospital

Certificate Effective DateJanuary 3, 2025

Certificate Expiration DateJanuary 2, 2027

Laboratory DirectorJames Harris

Laboratory Phone(760) 946-8620

Laboratory LocationSt. Mary Medical Center Dba Providence St Mary Medical Center18300 Hwy 18, Apple Valley, CA 92307

CLIA data matches this NPI record on: Name

This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. GLORIA ANNE PEAK FNP

Nurse Practitioner (Family)

18077 US HIGHWAY 18
APPLE VALLEY, CA 92307

San Bernardino County (760) 946-8169

LAURIE ROBERTS CNM

Advanced Practice Midwife

18077 US HIGHWAY 18, SUITE 100
APPLE VALLEY, CA 92307

San Bernardino County (760) 946-8799

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is St. Mary Medical Center's NPI number?

The NPI number for St. Mary Medical Center is 1043406440. It was assigned to this organization in the NPPES registry on September 19, 2007. The provider is doing business as Providence St. Mary Medical Center.

Where is St. Mary Medical Center located?

St. Mary Medical Center is located at 18077 Us Highway 18, Apple Valley, CA 92307. The listed phone number is (760) 946-8169.

What is St. Mary Medical Center's specialty?

The primary specialty registered for this NPI is Advanced Practice Midwife with taxonomy code 367A00000X.

Does St. Mary Medical Center hold CLIA laboratory certificates?

Yes. 3 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for St. Mary Medical Center was last updated on December 16, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.