Active NPI
Julie Kaye Clark, IBLCE
- Lactation Consultant (Non-RN)
- Frederick, MD
National Provider Identifier
1689918450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Non-RN)
- License
- 11216325
- Practice address
- 1301 Motter Avenue
Frederick, MD 21701 - Phone
- (301) 246-2556
- NPI assigned
- Nov 19, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | 11216325 | MD | Primary |
Addresses
Primary practice location
1301 Motter Avenue
Frederick, MD 21701
Mailing address
4001 Buckeystown Pike
P. O. Box
Buckeystown, MD 21717
Phone (301) 246-2556
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11216325 | MD | MD | Lactation Consultant (Non-RN) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353283200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353283200000",
"number": "1689918450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4001 BUCKEYSTOWN PIKE",
"address_2": "P. O. BOX",
"city": "BUCKEYSTOWN",
"state": "MD",
"postal_code": "21717",
"telephone_number": "301-246-2556"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 MOTTER AVENUE",
"city": "FREDERICK",
"state": "MD",
"postal_code": "21701",
"telephone_number": "301-246-2556"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "JULIE",
"middle_name": "KAYE",
"name_prefix": "Ms.",
"credential": "IBLCE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-19",
"last_updated": "2012-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": "MD",
"license": "11216325",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.