Individual provider Active NPI

Jennifer Scesa Duckles, RN, IBCLC

  • Lactation Consultant (Registered Nurse)
  • Collingswood, NJ
National Provider Identifier
1710303177
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
11044552 Issued in PA
Practice address
915 Haddon Ave
Collingswood, NJ 08108-1900
Phone
(856) 942-4305
NPI assigned
Mar 10, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X RN559169 PA
Lactation Consultant (Registered Nurse) 163WL0100X 11044552 PA Primary

Addresses

Primary practice location

915 Haddon Ave
Collingswood, NJ 08108-1900

Mailing address

915 Haddon Ave
Collingswood, NJ 08108-1900
Phone (856) 942-4305

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
Registered Nurse

State licenses

LicenseStateTypeSpecialty
11044552PAMDLactation Consultant (Registered Nurse)
RN559169PAMDLactation Consultant (Registered Nurse)

Practice roles

OrganizationSpecialtyStatusNew patients
The Village - South Jersey Breastfeeding & Wellness Lactation Consultant Current Accepting new patients

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": "1394409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1710303177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HADDON AVE",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081081900",
            "telephone_number": "856-942-4305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 HADDON AVE",
            "city": "COLLINGSWOOD",
            "state": "NJ",
            "postal_code": "081081900",
            "telephone_number": "856-942-4305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKLES",
        "first_name": "JENNIFER",
        "middle_name": "SCESA",
        "credential": "RN, IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-10",
        "last_updated": "2021-04-20",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "PA",
            "license": "RN559169",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "PA",
            "license": "11044552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collingswood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.