Individual provider Active NPI

Marisa B O'Connor

  • Lactation Consultant (Non-RN)
  • Colorado Springs, CO
National Provider Identifier
1871233676
Registry record updated Mar 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L-302838 Issued in CO
Practice address
4004 Mallow Rd
Colorado Springs, CO 80907-4407
Phone
(719) 235-1127
NPI assigned
Mar 30, 2022
Last updated
Mar 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2022

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 L-302838 CO Primary

Addresses

Primary practice location

4004 Mallow Rd
Colorado Springs, CO 80907-4407

Mailing address

4004 Mallow Rd
Colorado Springs, CO 80907-4407
Phone (719) 235-1127

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.pikespeaklactation.com/janeapp Direct Pikes Peak Lactation

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
L-302838COMDLactation Consultant (Non-RN)

Practice roles

OrganizationSpecialtyStatusNew patients
Pikes Peak Lactation Lactation Consultant, Non-RN PastSince Apr 3, 2022 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648598400000",
    "number": "1871233676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 MALLOW RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809074407",
            "telephone_number": "719-235-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 MALLOW RD",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809074407",
            "telephone_number": "719-235-1127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'CONNOR",
        "first_name": "MARISA",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-03-30",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "CO",
            "license": "L-302838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.pikespeaklactation.com/janeapp",
            "affiliation": "Y",
            "endpointDescription": "scheduling website with direct messaging",
            "affiliationName": "Pikes Peak Lactation",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4004 Mallow Rd",
            "city": "Colorado Springs",
            "state": "CO",
            "country_code": "US",
            "postal_code": "809074407",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2022; 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.