Active NPI
Jordan King
- Lactation Consultant (Registered Nurse)
- Saint Louis, MO
National Provider Identifier
1124829833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Registered Nurse)
- License
- 2015036804
- Practice address
- 6420 Clayton Rd
Saint Louis, MO 63117-1811 - Phone
- (618) 604-2833
- NPI assigned
- Mar 20, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Registered Nurse) | 163WL0100X | 2015036804 | MO | Primary |
Addresses
Primary practice location
6420 Clayton Rd
Saint Louis, MO 63117-1811
Mailing address
1157 N Moore St
Waterloo, IL 62298-5409
Phone (618) 604-2833
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2015036804 | MO | MD | Lactation Consultant (Registered Nurse) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1742428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742428800000",
"number": "1124829833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1157 N MOORE ST",
"city": "WATERLOO",
"state": "IL",
"postal_code": "622985409",
"telephone_number": "618-604-2833"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6420 CLAYTON RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631171811",
"telephone_number": "618-604-2833"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "JORDAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-03-20",
"last_updated": "2025-03-20",
"certification_date": "2025-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "163WL0100X",
"taxonomy_group": "",
"desc": "Registered Nurse, Lactation Consultant",
"state": "MO",
"license": "2015036804",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.