Lori Shad

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-60764 Issued in FL

Practice address

1616 Seminole Rd
Jacksonville, FL 32205-8635

Phone

(904) 485-0861

NPI assigned

Dec 8, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lori Rebman Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1417996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1598163529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 SEMINOLE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322058635",
            "telephone_number": "904-485-0861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 SEMINOLE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322058635",
            "telephone_number": "904-485-0861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAD",
        "first_name": "LORI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-12-08",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "FL",
            "license": "L-60764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "REBMAN",
            "credential": "IBCLC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tamir Shabazz
• Emily Zinger Shabbir, PA
• Eva Shabo, OD
• Robert Shackelford
• Brittni Shackleford
• Rachael Morrow Shad, APRN
• Elizabeth Burty Shadden, LMHC
• Paige Shadden
• Shades of Autism Parent Network, Inc.
• Michael Shaeffer, DMD

• Lactation Consultant (Non-RN) in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Lactation Consultant (Non-RN) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.