Colleen R Sopp, RN IBCLC

Primary specialty

Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X

License

206303 Issued in NC

Practice address

1800 Misty Hollow LN
Apex, NC 27502-6222

Phone

(919) 219-2680

NPI assigned

Feb 28, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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.

• Credo Lactation LLC

  • Lactation Consultant (Registered Nurse)
  • Apex, NC
  • NPI 1295450484
  NPD Authorized official

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665360000000",
    "number": "1891441994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MISTY HOLLOW LN",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275026222",
            "telephone_number": "919-219-2680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 MISTY HOLLOW LN",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275026222",
            "telephone_number": "919-219-2680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOPP",
        "first_name": "COLLEEN",
        "middle_name": "R",
        "credential": "RN IBCLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-10-10",
        "certification_date": "2022-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NC",
            "license": "206303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Lowell Smoot, MD
• Solas Mental Wellness, PLLC
• Scott M. Solomon, M.D.
• Dae Kyong Song
• Jennifer Ann Soper
• Mikayla Sortisio
• Sounding Stone Counseling & Wellness, PLLC
• South Branch Behavioral Health & Education
• Southern Medical Supply, LLC
• Southern Pines Prescription Shop Inc

• Lactation Consultant (Registered Nurse) in Apex, NC
• Providers in Apex, NC by specialty
• Lactation Consultant (Registered Nurse) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.