Individual provider Active NPI

Sharon Ann Reilly, RN, BSN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Rochester, NY
National Provider Identifier
1043836869
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
318900-1 Issued in NY
Practice address
910 North Goodman Street
Suite 1
Rochester, NY 14609
Phone
(585) 738-2507
NPI assigned
Jun 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse)Group: 193200000X MULTI-SPECIALTY GROUP 163WL0100X L-161927 VA
Lactation Consultant (Registered Nurse)Group: 193200000X MULTI-SPECIALTY GROUP 163WL0100X 318900-1 NY Primary

Addresses

Primary practice location

910 North Goodman Street
Suite 1
Rochester, NY 14609

Mailing address

910 North Goodman Street
Suite 1
Rochester, NY 14609
Phone (585) 738-2507

Other identifiers 1

IdentifierTypeStateIssuer
02773453MedicaidNY

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
318900-1NYMDLactation Consultant (Registered Nurse)
L-161927VAMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Living Hope Lactation Services Lactation Consultant CurrentSince Aug 23, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1043836869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 NORTH GOODMAN STREET",
            "address_2": "SUITE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14609",
            "telephone_number": "585-738-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 NORTH GOODMAN STREET",
            "address_2": "SUITE 1",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "14609",
            "telephone_number": "585-738-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REILLY",
        "first_name": "SHARON",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "RN, BSN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "VA",
            "license": "L-161927",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NY",
            "license": "318900-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02773453",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.