Lydia Lizeth Kennedy, NUTRITIONIST, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-302127 Issued in MO

Practice address

4750 E Royal Dr
Springfield, MO 65809-2422

Phone

(417) 406-6107

NPI assigned

Mar 17, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1962087395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 E ROYAL DR",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658092422",
            "telephone_number": "417-406-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4750 E ROYAL DR",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658092422",
            "telephone_number": "417-406-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENNEDY",
        "first_name": "LYDIA",
        "middle_name": "LIZETH",
        "credential": "NUTRITIONIST, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133NN1002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "MO",
            "license": "L-302127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Springfield",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Springfield",
            "address_1": "4750 E Royal Dr",
            "city": "Springfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "658092422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Susan L Keltner
• Elizabeth Kemper
• Sara R Kemper, PA-C
• Nathaniel Levi Kenady, FNP-BC
• Terry Vincent Kendrick, PLPC
• Megan Kennedy, ATC
• Nickalaus Craig Kennedy
• Samantha Margaret Kennemer, FNP
• Jeanene K Kennett, FNP
• Bernard Kennetz Jr., M.D

• Lactation Consultant (Non-RN) in Springfield, MO
• Providers in Springfield, MO by specialty
• Lactation Consultant (Non-RN) in Missouri

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