Individual provider Active NPI

Katrina Assunta Rochon Gomez, CLC

  • Lactation Consultant (Non-RN)
  • Ballston Lake, NY
National Provider Identifier
1942870134
Registry record updated Jun 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
329140 Issued in NY
Practice address
773 Charlton Rd
Ballston Lake, NY 12019-2803
Phone
(541) 361-0339
NPI assigned
Jun 29, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2021

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 329140 NY Primary

Addresses

Primary practice location

773 Charlton Rd
Ballston Lake, NY 12019-2803

Mailing address

773 Charlton Rd
Ballston Lake, NY 12019-2803
Phone (541) 361-0339

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1942870134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "773 CHARLTON RD",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192803",
            "telephone_number": "541-361-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "773 CHARLTON RD",
            "city": "BALLSTON LAKE",
            "state": "NY",
            "postal_code": "120192803",
            "telephone_number": "541-361-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOMEZ",
        "first_name": "KATRINA",
        "middle_name": "ASSUNTA ROCHON",
        "credential": "CLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "NY",
            "license": "329140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballston Lake, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; 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.