Individual provider Active NPI

Katelyn Suzanne Rogers, RNC

  • Lactation Consultant (Registered Nurse)
  • Mount Pleasant, SC
National Provider Identifier
1295490191
Registry record updated Nov 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
225805 Issued in SC
Practice address
1041 Johnnie Dodds Blvd Ste 14B
Mount Pleasant, SC 29464-6156
Phone
(843) 509-2851
NPI assigned
Nov 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2021

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 225805 SC Primary

Addresses

Primary practice location

1041 Johnnie Dodds Blvd Ste 14B
Mount Pleasant, SC 29464-6156

Mailing address

3149 Treadwell St
Mount Pleasant, SC 29466-9229
Phone (843) 810-3473

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
225805SCMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1635984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635984000000",
    "number": "1295490191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3149 TREADWELL ST",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294669229",
            "telephone_number": "843-810-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1041 JOHNNIE DODDS BLVD STE 14B",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294646156",
            "telephone_number": "843-509-2851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "KATELYN",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "RNC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-04",
        "last_updated": "2021-11-04",
        "certification_date": "2021-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "SC",
            "license": "225805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

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