LISA DOWNTON, CNM
Advanced Practice Midwife in CRESTVIEW HILLS, Kentucky. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.
What stands out: LISA DOWNTON, CNM reported a CMS MIPS final score of 90.3837 out of 100, above the 83.1 national average, and filed 88 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.
LISA DOWNTON, CNM at a glance
High performer (top quartile)Primary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in Kentucky
How Advanced Practice Midwife compares to other specialties among Kentucky providers
Advanced Practice Midwife share within Kentucky
Advanced Practice Midwife is one of the more visible NUCC categories in Kentucky
Each bar reflects the share of in-state providers whose primary NUCC taxonomy matches the specialty. Long tail of ~690 NUCC codes folded into "Other" to keep the comparison legible.
Medicare quality performance — MIPS
LISA DOWNTON, CNM's 2023 MIPS final score plotted against the Advanced Practice Midwife national average
- MIPS Final Score
- 90.3837/100
- vs 83.1 national avg · 2023 performance year
MIPS final score (Advanced Practice Midwife) — 90.3837/100 vs national avg 83.1
Quality benchmarks
- National MIPS avg 2023 reporting year
- Quality dim CMS Quality category
- Specialty volume Advanced Practice Midwife US NPIs
90.3837/100 MIPS final score — 7.3 pts above the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Advanced Practice Midwife. Quality dim: 80.7674.
The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.
Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).
LISA DOWNTON, CNM is a Advanced Practice Midwife provider practicing in CRESTVIEW HILLS, Kentucky, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: CNM. NPI: 1144560996. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.
LISA DOWNTON, CNM appears in the CMS NPPES registry as a Advanced Practice Midwife provider holding CNM credentials at 351 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY, 41017, with a listed phone of (859) 331-4665. NPI 1144560996 was issued on 02/15/2013. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what DOWNTON most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.
Medicare Part D records for calendar year 2023 show 88 prescription claims written by this provider, covering 35 Medicare beneficiaries and totaling roughly $6K in drug spend. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 90.3837/100 for the 2023 performance year (Quality 80.7674), compared with the national average of 83.1.
Advanced Practice Midwife is a mid-sized specialty nationwide, with 10,893 enrolled providers across 55 states and an average of 99 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.
Practice Address
Provider Details
| NPI | 1144560996 |
|---|---|
| Specialty | Advanced Practice Midwife |
| Credentials | CNM |
| Gender | Female |
| NPI Issued | 02/15/2013 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm LISA DOWNTON, CNM's current license status, disciplinary history, and board certifications with the Kentucky Board of Medical Licensure in Kentucky before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Alternative Payment Model
Hospital and facility affiliations
Facilities where LISA DOWNTON, CNM bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.
Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).
Industry payments received (2024) — CMS Open Payments transparency data
The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for LISA DOWNTON, CNM. Source: openpaymentsdata.cms.gov.
Total received
$290
Largest payer
MAYNE PHARMA COMMERCIAL LLC
Most common payment type
Food and Beverage
Industry payments are not necessarily indicators of bias — they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.
Medicare Part D Prescribing Data
CMS Medicare Part D prescriber-level data for calendar year 2023.
Prescribing Breakdown
- 30-Day Fills
- 135
- Total Day Supply
- 2,883
- Generic Drug Cost
- $2K
- Antibiotic Claims
- 20
Patient Demographics
- Average Patient Age
- 62.1 years
- Avg HCC Risk Score
- 1.13
- Gender Split
- 100% female / 0% male
- Age Distribution
- <65: 15, 65-74: 17, 75-84: N/A, 85+: N/A
Top Prescribed Drugs (Medicare Part D)
Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.
| Drug | Claims |
|---|---|
| Fluconazole | 21 |
| Estradiol | 15 |
* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.
Advanced Practice Midwife Overview
How LISA DOWNTON, CNM fits within the Advanced Practice Midwife landscape nationally.
LISA DOWNTON, CNM's 88 claims are below the specialty average of 99.
Nearby Advanced Practice Midwife Providers in Kentucky
Other clinicians with the same primary specialty enrolled in Kentucky, drawn from the same CMS NPPES roster as DOWNTON.
Compare Advanced Practice Midwife nationally: see state-by-state distribution →
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Frequently Asked Questions
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Data Sources
- Provider Directory
- CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
- Specialty Classification
- NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
- Prescribing Data
- CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
- Quality Performance
- CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
- Limitations
- Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.
See our complete data methodology for details on how we collect and process government data.
Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).
Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology