Individual provider Active NPI

Deborah Lyn Gillespie, IBCLC, RLC

  • Lactation Consultant (Non-RN)
  • Chandler, AZ
National Provider Identifier
1962617902
Registry record updated Sep 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Non-RN)Taxonomy code 174N00000X
License
105-22185 Issued in AZ
Practice address
3355 W Chandler Blvd
Suite 3
Chandler, AZ 85226-5096
Phone
(480) 786-0431
Fax
(480) 745-3615
NPI assigned
May 12, 2007
Last updated
Sep 11, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2012

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 105-22185 AZ Primary

Addresses

Primary practice location

3355 W Chandler Blvd
Suite 3
Chandler, AZ 85226-5096

Mailing address

1502 E Hermosa Dr
Tempe, AZ 85282-5722
Phone (480) 786-0431

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
105-22185AZMDLactation Consultant (Non-RN)

NPI Registry JSON

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

{
    "created_epoch": "1178928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347321600000",
    "number": "1962617902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 E HERMOSA DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852825722",
            "telephone_number": "480-786-0431",
            "fax_number": "480-745-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 W CHANDLER BLVD",
            "address_2": "SUITE 3",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852265096",
            "telephone_number": "480-786-0431",
            "fax_number": "480-745-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLESPIE",
        "first_name": "DEBORAH",
        "middle_name": "LYN",
        "credential": "IBCLC, RLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-12",
        "last_updated": "2012-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "",
            "desc": "Lactation Consultant, Non-RN",
            "state": "AZ",
            "license": "105-22185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2012; 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.