Individual provider Active NPI

Jennifer Michelle Chivas, RN, BSN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Lakewood Ranch, FL
National Provider Identifier
1487161303
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
9476132 Issued in FL
Practice address
7345 International PL Ste 109
Lakewood Ranch, FL 34240-8468
Phone
(941) 254-2502
NPI assigned
Dec 30, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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 9476132 FL Primary

Addresses

Primary practice location

7345 International PL Ste 109
Lakewood Ranch, FL 34240-8468

Mailing address

30152 Turtle Creek Cir
New Hudson, MI 48165-0008
Phone (248) 207-3070

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
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
9476132FLMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Ranch Lactation Lactation Consultant CurrentSince Jan 26, 2022 Accepting new patients

Locations

7345 International Pl
Ste 109
Lakewood Ranch, FL 34240
Phone (941) 254-2502

10407 Grand River Rd
Ste 600
Brighton, MI 48116
Phone (810) 227-9015

3201 Teasley Ln
Ste 302
Denton, TX 76210

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": "1514592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1487161303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30152 TURTLE CREEK CIR",
            "city": "NEW HUDSON",
            "state": "MI",
            "postal_code": "481650008",
            "telephone_number": "248-207-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7345 INTERNATIONAL PL STE 109",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342408468",
            "telephone_number": "941-254-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIVAS",
        "first_name": "JENNIFER",
        "middle_name": "MICHELLE",
        "credential": "RN, BSN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-30",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "FL",
            "license": "9476132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood Ranch, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.