Individual provider Active NPI

Carol Ann Madruga, RN451318

  • Lactation Consultant (Registered Nurse)
  • Merced, CA
National Provider Identifier
1073163655
Registry record updated Sep 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
RN451318 Issued in CA
Practice address
1721 Poppy Hills CT
Merced, CA 95340-0761
Phone
(209) 631-7441
NPI assigned
Sep 16, 2019
Last updated
Sep 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2019

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 RN451318 CA Primary

Addresses

Primary practice location

1721 Poppy Hills CT
Merced, CA 95340-0761

Mailing address

1721 Poppy Hills CT
Merced, CA 95340-0761
Phone (209) 631-7441

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
RN451318CAMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568592000000",
    "number": "1073163655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 POPPY HILLS CT",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400761",
            "telephone_number": "209-631-7441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 POPPY HILLS CT",
            "city": "MERCED",
            "state": "CA",
            "postal_code": "953400761",
            "telephone_number": "209-631-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADRUGA",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "credential": "RN451318",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-16",
        "last_updated": "2019-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "RN451318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merced, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2019; 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.