Individual provider Active NPI

Carisa Myers, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Bridgeport, CT
National Provider Identifier
1407502909
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
L306504 Issued in CT
Practice address
116 Peet St
Bridgeport, CT 06606-3475
Phone
(475) 344-9944
NPI assigned
Feb 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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 L306504 CT Primary

Addresses

Primary practice location

116 Peet St
Bridgeport, CT 06606-3475

Mailing address

116 Peet St
Bridgeport, CT 06606-3475

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
L306504NYMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1407502909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 PEET ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 PEET ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066063475",
            "telephone_number": "475-344-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "CARISA",
        "name_prefix": "Mrs.",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-23",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "CT",
            "license": "L306504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.