Individual provider Active NPI

Kelly Williams

  • Lactation Consultant (Non-RN)
  • Greenwell Springs, LA
National Provider Identifier
1013777481
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L-309153 Issued in LA
Practice address
18645 Greenwell Springs Rd Apt 3
Greenwell Springs, LA 70739-4841
Phone
(225) 235-7509
NPI assigned
Mar 21, 2024
Last updated
Mar 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 30001492 LA
Lactation Consultant (Non-RN) 174N00000X L-309153 LA Primary

Addresses

Primary practice location

18645 Greenwell Springs Rd Apt 3
Greenwell Springs, LA 70739-4841

Mailing address

8713 Loch Fyne Ave
Baker, LA 70714-7039

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
30001492LAMDLicensed Practical Nurse
L-309153LAMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1013777481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8713 LOCH FYNE AVE",
            "city": "BAKER",
            "state": "LA",
            "postal_code": "707147039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18645 GREENWELL SPRINGS RD APT 3",
            "city": "GREENWELL SPRINGS",
            "state": "LA",
            "postal_code": "707394841",
            "telephone_number": "225-235-7509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "LA",
            "license": "30001492",
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "LA",
            "license": "L-309153",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwell Springs, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.