Jordan Laxson Clarke

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

1-162578 Issued in AL

Practice address

2100 Beverly Hills Dr
Vestavia Hills, AL 35216-1704

Phone

(205) 862-1892

NPI assigned

May 10, 2021

Last updated

May 10, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Birmingham Breastfeeding LLC

  • Lactation Consultant (Registered Nurse)
  • Vestavia Hills, AL
  • NPI 1609502525
  NPD Authorized official

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1083298731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 BEVERLY HILLS DR",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352161704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 BEVERLY HILLS DR",
            "city": "VESTAVIA HILLS",
            "state": "AL",
            "postal_code": "352161704",
            "telephone_number": "205-862-1892"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "JORDAN",
        "middle_name": "LAXSON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "AL",
            "license": "1-162578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Champion Sports Medicine Birmingham, LLC. (Champion Sports Medicine)
• Rachel Lyn Chickvara, ALC
• Child Psychological Services, Inc.
• Holly M Church, R.PH.
• Lindsey Nicole Clark Ward, M.D.
• Stefanie Smith Cleveland, PHARMD
• Riley Cockerill, PT
• James Price Colvard, D.O.
• Margaret Colvert, LMT
• Presley Joan Compton

• Lactation Consultant (Registered Nurse) in Vestavia Hills, AL
• Providers in Vestavia Hills, AL by specialty
• Lactation Consultant (Registered Nurse) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 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.