Active NPI
Cathryn Clark
- Lactation Consultant (Non-RN)
- Austin, TX
National Provider Identifier
1306257761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Non-RN)
- License
- L-16605
- Practice address
- 4131 Spicewood Springs Rd
Suite C1
Austin, TX 78759-8661 - Phone
- (512) 873-0700
- Fax
- (512) 340-9908
- NPI assigned
- May 19, 2014
- Last updated
- May 19, 2014
- 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-16605 | VA | Primary |
Addresses
Primary practice location
4131 Spicewood Springs Rd
Suite C1
Austin, TX 78759-8661
Mailing address
4131 Spicewood Springs Rd
Suite C1
Austin, TX 78759-8661
Phone (512) 873-0700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| L-16605 | Other | VA | IBLCE |
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-16605 | VA | MD | Lactation Consultant (Non-RN) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400457600000",
"number": "1306257761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4131 SPICEWOOD SPRINGS RD",
"address_2": "SUITE C1",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787598661",
"telephone_number": "512-873-0700",
"fax_number": "512-340-9908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4131 SPICEWOOD SPRINGS RD",
"address_2": "SUITE C1",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787598661",
"telephone_number": "512-873-0700",
"fax_number": "512-340-9908"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "CATHRYN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-05-19",
"last_updated": "2014-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": "VA",
"license": "L-16605",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBLCE",
"identifier": "L-16605",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.