Kristin Rose Fors, RN, IBCLC

Primary specialty

Lactation Consultant (Non-RN)Taxonomy code 174N00000X

License

L-15532 Issued in FL

Practice address

4251 Commons Dr W Unit 5108
Destin, FL 32541-8635

Phone

(770) 722-6352

NPI assigned

Jun 16, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655337600000",
    "number": "1982334355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4251 COMMONS DR W UNIT 5108",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418635",
            "telephone_number": "770-722-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4251 COMMONS DR W UNIT 5108",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325418635",
            "telephone_number": "770-722-6352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORS",
        "first_name": "KRISTIN",
        "middle_name": "ROSE",
        "credential": "RN, IBCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2022-06-16",
        "certification_date": "2022-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Lactation Consultant, Non-RN",
            "state": "FL",
            "license": "L-15532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "http://www.emeraldshoreslactationresources.com/",
            "affiliation": "N",
            "endpointDescription": "My company website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4251 Commons Dr W Unit 5108",
            "city": "Destin",
            "state": "FL",
            "country_code": "US",
            "postal_code": "325418635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• All providers in Destin, FL
• Lactation Consultant (Non-RN) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2022; 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.