Individual provider Active NPI

Shammah Kris Delasse, IBCLC

  • Lactation Consultant (Non-RN)
  • Tulsa, OK
National Provider Identifier
1467739359
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
11190051 Issued in VA
Practice address
2211 N Lewis PL
Tulsa, OK 74110-2125
Phone
(918) 902-9368
NPI assigned
Nov 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN) 174N00000X 11190051 VA Primary

Addresses

Primary practice location

2211 N Lewis PL
Tulsa, OK 74110-2125

Mailing address

2211 N Lewis PL
Tulsa, OK 74110-2125
Phone (918) 902-9368

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
11190051VAMDLactation Consultant (Non-RN)

Practice roles

OrganizationSpecialtyStatusNew patients
Breastfeeding Connections Lactation Consultant, Non-RN Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1320624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320624000000",
    "number": "1467739359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 N LEWIS PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741102125",
            "telephone_number": "918-902-9368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 N LEWIS PL",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741102125",
            "telephone_number": "918-902-9368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELASSE",
        "first_name": "SHAMMAH",
        "middle_name": "KRIS",
        "name_prefix": "Mrs.",
        "credential": "IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-07",
        "last_updated": "2011-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "VA",
            "license": "11190051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; 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.