NPIMap

Individual provider Active NPI

Laene M Keith

  • Lactation Consultant (Non-RN)
  • Viera, FL
National Provider Identifier
1174808695
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L-22092 Issued in FL
Practice address
5208 Wexford Dr
Viera, FL 32955-6704
Phone
(321) 271-7990
NPI assigned
Oct 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X SA6260 FL
Lactation Consultant (Non-RN) 174N00000X L-22092 FL Primary

Addresses

Primary practice location

5208 Wexford Dr
Viera, FL 32955-6704

Mailing address

5208 Wexford Dr
Viera, FL 32955-6704

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
L-22092FLMDLactation Consultant (Non-RN)
SA6260FLMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aeroflow Connect LLC Lactation Consultant, Non-RN Past 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": "1318723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1174808695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5208 WEXFORD DR",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329556704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5208 WEXFORD DR",
            "city": "VIERA",
            "state": "FL",
            "postal_code": "329556704",
            "telephone_number": "321-271-7990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "LAENE",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-16",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA6260",
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "FL",
            "license": "L-22092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Viera, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.