Individual provider Active NPI

Shannon Marie Lilienthal, IBCLC

  • Lactation Consultant (Non-RN)
  • Mechanicsburg, PA
National Provider Identifier
1568708121
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
10421137 Issued in PA
Practice address
327 Charles Rd
Mechanicsburg, PA 17050-3006
Phone
(717) 712-6822
NPI assigned
Dec 28, 2012
Last updated
Dec 28, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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 10421137 PA Primary

Addresses

Primary practice location

327 Charles Rd
Mechanicsburg, PA 17050-3006

Mailing address

327 Charles Rd
Mechanicsburg, PA 17050-3006
Phone (717) 712-6822

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
10421137PAMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1356652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1568708121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 CHARLES RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503006",
            "telephone_number": "717-712-6822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 CHARLES RD",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170503006",
            "telephone_number": "717-712-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LILIENTHAL",
        "first_name": "SHANNON",
        "middle_name": "MARIE",
        "credential": "IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-28",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "PA",
            "license": "10421137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mechanicsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2012; 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.