Rebecca Boedeker, RN

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

094863 Issued in MO

Practice address

6420 Clayton Rd
Richmond Heights, MO 63117-1811

Phone

(314) 768-8722

NPI assigned

Sep 14, 2019

Last updated

Sep 14, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1568419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568419200000",
    "number": "1477103182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-768-8722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6420 CLAYTON RD",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631171811",
            "telephone_number": "314-768-8722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEDEKER",
        "first_name": "REBECCA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-14",
        "last_updated": "2019-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "MO",
            "license": "094863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "becky.boedeker@ssmhealth.com",
            "affiliation": "N",
            "address_1": "6420 Clayton Rd",
            "city": "Richmond Heights",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631171811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Lactation Consultant (Registered Nurse) in Richmond Heights, MO
• Providers in Richmond Heights, MO by specialty
• Lactation Consultant (Registered Nurse) in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2019; 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.