Individual provider Active NPI

Snow Verdean Harper-Moulton, RN IBCLC

  • Lactation Consultant (Registered Nurse)
  • Massena, NY
National Provider Identifier
1194331538
Registry record updated Sep 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
476483 Issued in NY
Practice address
428 County Route 37
Massena, NY 13662-3362
Phone
(315) 600-1007
NPI assigned
Sep 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2020

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 476483 NY Primary

Addresses

Primary practice location

428 County Route 37
Massena, NY 13662-3362

Mailing address

428 County Route 37
Massena, NY 13662-3362
Phone (315) 600-1007

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL https://drive.google.com/drive/my-drive Direct

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
476483NYMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600646400000",
    "number": "1194331538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 COUNTY ROUTE 37",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136623362",
            "telephone_number": "315-600-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 COUNTY ROUTE 37",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136623362",
            "telephone_number": "315-600-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARPER-MOULTON",
        "first_name": "SNOW",
        "middle_name": "VERDEAN",
        "credential": "RN IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-09-21",
        "certification_date": "2020-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NY",
            "license": "476483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://drive.google.com/drive/my-drive",
            "affiliation": "N",
            "endpointDescription": "Cloud",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "428 County Route 37",
            "city": "Massena",
            "state": "NY",
            "country_code": "US",
            "postal_code": "136623362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Massena, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2020; 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.