Individual provider Active NPI

Stephanie Pappas-Hudelson, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Fort Leavenworth, KS
National Provider Identifier
1306596333
Registry record updated Jan 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
L-314029 Issued in KS
Practice address
811 4TH Artillery Rd
Fort Leavenworth, KS 66027
Phone
(917) 408-3102
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 14-161195-112 KS
Registered Nurse 163W00000X 831771 NY
Lactation Consultant (Registered Nurse) 163WL0100X 831771 NY
Lactation Consultant (Registered Nurse) 163WL0100X L-314029 KS Primary

Addresses

Primary practice location

811 4TH Artillery Rd
Fort Leavenworth, KS 66027

Mailing address

811 4TH Artillery Rd
Fort Leavenworth, KS 66027-1179
Phone (917) 408-3102

Other practice location 1

346 N Montgomery St
Newburgh, NY 12550-3642
Phone (609) 516-7184

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
14-161195-112KSMDRegistered Nurse
L-314029KSMDLactation Consultant (Registered Nurse)
831771NYMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704153600000",
    "number": "1306596333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 4TH ARTILLERY RD",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "660271179",
            "telephone_number": "917-408-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 4TH ARTILLERY RD",
            "city": "FORT LEAVENWORTH",
            "state": "KS",
            "postal_code": "66027",
            "telephone_number": "917-408-3102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "346 N Montgomery St",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "NY",
            "postal_code": "125503642",
            "country_code": "US",
            "telephone_number": "609-516-7184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAPPAS-HUDELSON",
        "first_name": "STEPHANIE",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2024-01-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "14-161195-112",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "831771",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NY",
            "license": "831771",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "KS",
            "license": "L-314029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Leavenworth, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.