Individual provider Active NPI

Amanda M Deweese, MPH, CPH, IBCLC

  • Lactation Consultant (Non-RN)
  • Land O Lakes, FL
National Provider Identifier
1912400771
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
L-116572 Issued in FL
Practice address
4601 Marchmont Blvd
Land O Lakes, FL 34638-7764
Phone
(813) 205-4889
NPI assigned
Mar 17, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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-116572 FL Primary

Addresses

Primary practice location

4601 Marchmont Blvd
Land O Lakes, FL 34638-7764

Mailing address

4601 Marchmont Blvd
Land O Lakes, FL 34638-7764

Other names 1

  • Amanda M Boyle Former name

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-116572FLMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1521244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1912400771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4601 MARCHMONT BLVD",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346387764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4601 MARCHMONT BLVD",
            "city": "LAND O LAKES",
            "state": "FL",
            "postal_code": "346387764",
            "telephone_number": "813-205-4889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEESE",
        "first_name": "AMANDA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "MPH, CPH, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "FL",
            "license": "L-116572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMANDA",
            "last_name": "BOYLE",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Land O Lakes, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.