Individual provider Active NPI

Cynthia Rose Stuckey, RN LACTATION CONSULT

  • Lactation Consultant (Registered Nurse)
  • Portsmouth, VA
National Provider Identifier
1982811584
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Lactation Consultant (Registered Nurse)Taxonomy code 163WL0100X
License
0001088301 Issued in VA
Practice address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone
(757) 953-4775
Fax
(757) 953-0896
NPI assigned
May 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Lactation Consultant (Registered Nurse) 163WL0100X 0001088301 VA Primary

Addresses

Primary practice location

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Mailing address

4036 Breakwater Dr
Portsmouth, VA 23703-5319
Phone (757) 483-0391

Other identifiers 1

IdentifierTypeStateIssuer
1986199357OtherVARN LACTATION CONSULTANT

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
0001088301VAMDLactation Consultant (Registered Nurse)

NPI Registry JSON

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982811584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4036 BREAKWATER DR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237035319",
            "telephone_number": "757-483-0391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "757-953-4775",
            "fax_number": "757-953-0896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "CYNTHIA",
        "middle_name": "ROSE",
        "name_prefix": "Ms.",
        "credential": "RN LACTATION CONSULT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "VA",
            "license": "0001088301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LACTATION CONSULTANT",
            "identifier": "1986199357",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.