Individual provider Active NPI

Carly Marks

  • Lactation Consultant (Registered Nurse)
  • San Diego, CA
National Provider Identifier
1356735583
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
665665 Issued in CA
Practice address
13374 Terraza Playa Cancun
San Diego, CA 92124-1538
Phone
(619) 481-1000
NPI assigned
Mar 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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 665665 CA Primary

Addresses

Primary practice location

13374 Terraza Playa Cancun
San Diego, CA 92124-1538

Mailing address

13374 Terraza Playa Cancun
San Diego, CA 92124-1538
Phone (619) 481-1000

Other identifiers 2

IdentifierTypeStateIssuer
665665OtherCAREGISTERED NURSE
L-60664OtherIBCLC INTERNATIONAL BOARD CERTIFIED LACTATION CONSULTANT

Other names 1

  • Carly Young Former name

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
665665CAMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1427241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1356735583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13374 TERRAZA PLAYA CANCUN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921241538",
            "telephone_number": "619-481-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13374 TERRAZA PLAYA CANCUN",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921241538",
            "telephone_number": "619-481-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKS",
        "first_name": "CARLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-25",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CA",
            "license": "665665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTERED NURSE",
            "identifier": "665665",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBCLC INTERNATIONAL BOARD CERTIFIED LACTATION CONSULTANT",
            "identifier": "L-60664",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "YOUNG",
            "credential": "RN, IBCLC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; 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.