Individual provider Active NPI

Shardae McKoy, CLC

  • Lactation Consultant (Non-RN)
  • Fredericksburg, VA
National Provider Identifier
1750213161
Registry record updated Jun 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
Practice address
PO Box 5005
Fredericksburg, VA 22403-0605
Phone
(336) 624-3042
NPI assigned
Jun 1, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2026

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 Primary

Addresses

Primary practice location

PO Box 5005
Fredericksburg, VA 22403-0605

Mailing address

PO Box 5005
Fredericksburg, VA 22403-0605

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

NPI Registry JSON

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

{
    "created_epoch": "1780272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780272000000",
    "number": "1750213161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5005",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224030605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 5005",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224030605",
            "telephone_number": "336-624-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKOY",
        "first_name": "SHARDAE",
        "credential": "CLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-01",
        "last_updated": "2026-06-01",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2026; 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.