Shannon Gaydeski

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-107778

Practice address

310 New Bridge St
Jacksonville, NC 28540-4756

Phone

(910) 621-4266

Fax

(910) 613-0382

NPI assigned

Mar 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1295329332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 NEW BRIDGE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404756",
            "telephone_number": "910-621-4266",
            "fax_number": "910-613-0382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 NEW BRIDGE ST",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285404756",
            "telephone_number": "910-621-4266",
            "fax_number": "910-613-0382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAYDESKI",
        "first_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": "L-107778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "00000000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "belladonnamidwifery@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "310 New Bridge St",
            "city": "Jacksonville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "285404756",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Garnett, LCMHC, LCAS
• James E. Garrett, MD
• Rebecca Ann Gates, PA-C
• Gail Kimberly Gatewood
• Katrina Lynn Gauthier, FNP-C
• Ayla Gearhart
• Kayla Lynn Gee, PT, DPT
• Devinn L Geeson, DDS
• Zachary Geiger
• Generations Family Practice, PA (Andre KS Tse MD)

• Lactation Consultant (Non-RN) in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Lactation Consultant (Non-RN) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.