Individual provider Active NPI

Ellen Marie Chetwynd, RN BSN IBCLC MPH PHD

  • Lactation Consultant (Registered Nurse)
  • Chapel Hill, NC
National Provider Identifier
1902164833
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
115961 Issued in NC
Practice address
111 Knox Way Ste 110
Chapel Hill, NC 27516-6615
Phone
(919) 438-2293
Fax
(833) 523-2335
NPI assigned
Apr 28, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Non-RN)Group: 193200000X MULTI-SPECIALTY GROUP 174N00000X
Lactation Consultant (Registered Nurse) 163WL0100X 115961 NC Primary

Addresses

Primary practice location

111 Knox Way Ste 110
Chapel Hill, NC 27516-6615

Mailing address

3515 Hamlets Chapel Rd
Pittsboro, NC 27312-7129
Phone (919) 967-6960

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
Bachelor on Science - Nursing, Doctor of Philosophy, Registered Nurse

State licenses

LicenseStateTypeSpecialty
115961NCMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1335571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1902164833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 HAMLETS CHAPEL RD",
            "city": "PITTSBORO",
            "state": "NC",
            "postal_code": "273127129",
            "telephone_number": "919-967-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 KNOX WAY STE 110",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275166615",
            "telephone_number": "919-438-2293",
            "fax_number": "833-523-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHETWYND",
        "first_name": "ELLEN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "RN BSN IBCLC MPH PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-28",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "NC",
            "license": "115961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.