NPIMap

Organization Active NPI

Lactation Services of Waco, LLC

  • Lactation Consultant (Non-RN)
  • Waco, TX
National Provider Identifier
1336657212
Registry record updated Jan 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L-126587 Issued in NU
Legal business name
LACTATION SERVICES OF WACO, LLC
Practice address
1525 Austin Ave
Waco, TX 76701-1711
Phone
(254) 753-1987
NPI assigned
Jan 13, 2018
Last updated
Jan 18, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2018

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

Authorized official

Name
Tonja Denise Carpenter, IBCLC,PCDNPI 1083122964
Title
Owner
Phone
(254) 753-1987

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X L-126587 NU Primary

Addresses

Primary practice location

1525 Austin Ave
Waco, TX 76701-1711

Mailing address

2316 Gorman Ave
Waco, TX 76707-2862
Phone (254) 753-1987

Other identifiers 1

IdentifierTypeStateIssuer
L-126587OtherTXINTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS

National Provider Directory

National Provider Directory

Locations

1525 Austin Ave
Waco, TX 76701
Phone (254) 224-6062

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1515801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516233600000",
    "number": "1336657212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2316 GORMAN AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767072862",
            "telephone_number": "254-753-1987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 AUSTIN AVE",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767011711",
            "telephone_number": "254-753-1987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LACTATION SERVICES OF WACO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-13",
        "last_updated": "2018-01-18",
        "status": "A",
        "authorized_official_last_name": "CARPENTER",
        "authorized_official_first_name": "TONJA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "254-753-1987",
        "authorized_official_credential": "IBCLC,PCD"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "NU",
            "license": "L-126587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNATIONAL BOARD OF LACTATION CONSULTANT EXAMINERS",
            "identifier": "L-126587",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2018; 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.