Individual provider Active NPI

Shannon Michelle Lopez, LPN, IBCLC

  • Lactation Consultant (Non-RN)
  • Indianapolis, IN
National Provider Identifier
1194577833
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L-144374 Issued in IN
Practice address
8111 Township Line Rd
Indianapolis, IN 46260-2479
Phone
(317) 490-9427
NPI assigned
Apr 4, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X L-144374 IN Primary

Addresses

Primary practice location

8111 Township Line Rd
Indianapolis, IN 46260-2479

Mailing address

11347 Indian Creek Rd
Indianapolis, IN 46236-2908
Phone (317) 490-9427

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

LicenseStateTypeSpecialty
L-144374INMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1194577833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11347 INDIAN CREEK RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462362908",
            "telephone_number": "317-490-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8111 TOWNSHIP LINE RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462602479",
            "telephone_number": "317-490-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ",
        "first_name": "SHANNON",
        "middle_name": "MICHELLE",
        "credential": "LPN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "IN",
            "license": "L-144374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.