Individual provider Active NPI

Jenelle Donzelli Nemeth, BSN, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Corinth, NY
National Provider Identifier
1073091310
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
L-86564 Issued in NY
Practice address
34 Fuller Dr
Corinth, NY 12822-2321
Phone
(704) 746-2424
NPI assigned
Jul 30, 2018
Last updated
Jan 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X L-86564 NY Primary

Addresses

Primary practice location

34 Fuller Dr
Corinth, NY 12822-2321

Mailing address

34 Fuller Dr
Corinth, NY 12822-2321

Other practice location 1

102 sapphire drive
Mooresville, NC 28117
Phone (518) 888-4013

Other identifiers 1

IdentifierTypeStateIssuer
615812OtherNYRN

Other names 1

  • Jenelle Brooke Nemeth Former name

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
L-86564NYMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Savvy Care RN, OT, PLLC Lactation Consultant Current Accepting new patients
Forever Family Fitness: Breastfeeding Savvy Lactation Consultant Current Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1073091310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 FULLER DR",
            "city": "CORINTH",
            "state": "NY",
            "postal_code": "128222321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 FULLER DR",
            "city": "CORINTH",
            "state": "NY",
            "postal_code": "128222321",
            "telephone_number": "704-746-2424"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 sapphire drive",
            "address_purpose": "LOCATION",
            "city": "Mooresville",
            "state": "NC",
            "postal_code": "28117",
            "country_code": "US",
            "telephone_number": "518-888-4013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEMETH",
        "first_name": "JENELLE",
        "middle_name": "DONZELLI",
        "credential": "BSN, RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-30",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NY",
            "license": "L-86564",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "615812",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENELLE",
            "last_name": "NEMETH",
            "middle_name": "BROOKE",
            "credential": "BSN, RN, IBCLC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Corinth, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.