Active NPI
Randi Veronica Davis, IBCLC
- Lactation Consultant (Non-RN)
- Walkerton, IN
National Provider Identifier
1194499467
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Non-RN)
- License
- L-302748
- Practice address
- 1001 Colorado St
Walkerton, IN 46574-1086 - Phone
- (574) 386-6394
- NPI assigned
- Aug 2, 2021
- 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 (Non-RN) | 174N00000X | L-302748 | IN | Primary |
Addresses
Primary practice location
1001 Colorado St
Walkerton, IN 46574-1086
Mailing address
10275 Peotone Dr
Granger, IN 46530-7744
Phone (574) 386-6394
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 |
|---|---|---|---|
| L-302748 | IN | MD | Lactation Consultant (Non-RN) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685491200000",
"number": "1194499467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10275 PEOTONE DR",
"city": "GRANGER",
"state": "IN",
"postal_code": "465307744",
"telephone_number": "574-386-6394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 COLORADO ST",
"city": "WALKERTON",
"state": "IN",
"postal_code": "465741086",
"telephone_number": "574-386-6394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAVIS",
"first_name": "RANDI",
"middle_name": "VERONICA",
"credential": "IBCLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-02",
"last_updated": "2023-05-31",
"certification_date": "2023-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": "IN",
"license": "L-302748",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walkerton, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 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.