Mommas Village Fayetteville Inc

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

Legal business name

MOMMAS VILLAGE FAYETTEVILLE INC

Practice address

131 Hay St Ste 201
Fayetteville, NC 28301-6105

Phone

(910) 764-8314

NPI assigned

Dec 28, 2020

Organization subpart

No

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

Authorized official

Name

Angela Tatum Malloy, IBCLC, CD

Title

President/Ceo/Lactation Director

Phone

(910) 764-8314

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Angela Tatum Malloy

  • Lactation Consultant (Non-RN)
  • Fayetteville, NC
  • NPI 1447633615

  Lactation Consultant, Non-RN

  NPD

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609113600000",
    "number": "1528655487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53224",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283053224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 HAY ST STE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283016105",
            "telephone_number": "910-764-8314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOMMAS VILLAGE FAYETTEVILLE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-28",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-27",
        "status": "A",
        "authorized_official_last_name": "MALLOY",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "TATUM",
        "authorized_official_title_or_position": "PRESIDENT/CEO/LACTATION DIRECTOR",
        "authorized_official_telephone_number": "910-764-8314",
        "authorized_official_credential": "IBCLC, CD"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "angela@mommasvillage.org",
            "affiliation": "N",
            "endpointDescription": "EHR secure messaging",
            "address_1": "131 Hay St Ste 201",
            "city": "Fayetteville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "283016105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Pedro Juan Molinaarroyo, RBT
• Samantha Moline, RN
• Brittany Alexis Molnar
• Kimberly E Molnar, MED
• Megan Molter
• Ifeanyi Ifeoma Momodu, M.D.
• Kingsley Oise Momodu, D.D.S.
• Madeline Everitt Monday
• Elizabeth Ann Monge, LCMHC, LPA
• Adrienne Lynette Monroe, MSW, LCSW

• Lactation Consultant (Non-RN) in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Lactation Consultant (Non-RN) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.