Individual provider Active NPI

Shannon Leathers, RN BS IBCLC

  • Lactation Consultant (Registered Nurse)
  • Mifflinburg, PA
National Provider Identifier
1215874870
Registry record updated May 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
RN565957 Issued in PA
Practice address
222 Vista Dr
Mifflinburg, PA 17844-7261
Phone
(570) 701-7123
NPI assigned
May 1, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 1, 2026

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)Group: 193400000X SINGLE SPECIALTY GROUP 163WL0100X RN565957 PA Primary

Addresses

Primary practice location

222 Vista Dr
Mifflinburg, PA 17844-7261

Mailing address

222 Vista Dr
Mifflinburg, PA 17844-7261
Phone (570) 701-7123

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
RN565957PAMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1777593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777593600000",
    "number": "1215874870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 VISTA DR",
            "city": "MIFFLINBURG",
            "state": "PA",
            "postal_code": "178447261",
            "telephone_number": "570-701-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 VISTA DR",
            "city": "MIFFLINBURG",
            "state": "PA",
            "postal_code": "178447261",
            "telephone_number": "570-701-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERS",
        "first_name": "SHANNON",
        "name_prefix": "Mrs.",
        "credential": "RN BS IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-01",
        "last_updated": "2026-05-01",
        "certification_date": "2026-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "PA",
            "license": "RN565957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mifflinburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2026; 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.