Ellen Rose Obrien, LMT, CLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

332736 Issued in IA

Practice address

1130 Salm Dr
North Liberty, IA 52317-4889

Phone

(319) 325-5091

NPI assigned

Oct 20, 2010

Last updated

Jan 31, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Balanced Birth LLC

  • Lactation Consultant (Registered Nurse)
  • North Liberty, IA
  • NPI 1689363525
  NPD Authorized official

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1417267675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 SALM DR",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523174889",
            "telephone_number": "319-325-5091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 SALM DR",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523174889",
            "telephone_number": "319-325-5091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OBRIEN",
        "first_name": "ELLEN",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "LMT, CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-20",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "IA",
            "license": "332736",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "16467",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• North Liberty Smiles PLLC
• Byron Ezeugo Nwonye, DC
• Shellie Marie O'Brien-Perry, ARNP-C
• Geoffrey Ounda Obel
• Kristen I Oberman, DDS
• Christopher Gene Okiishi, MD
• Quincey G Ollendieck
• Kallie Jeane Olson
• Diana Zofia Olszewska
• Peter Omollo

• Lactation Consultant (Registered Nurse) in North Liberty, IA
• Providers in North Liberty, IA by specialty
• Lactation Consultant (Registered Nurse) in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2023; 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.