Active NPI
Shauna Kenealey, LM, CPM, IBCLC
- Midwife
- Comptche, CA
National Provider Identifier
1992948715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Midwife
- License
- LM399
- Practice address
- 26020 Comptche-Ukiah Rd
Comptche, CA 95427 - Phone
- (541) 727-1907
- Fax
- (541) 256-3772
- NPI assigned
- Apr 9, 2009
- Last updated
- Mar 10, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | L-22176 | ||
| Midwife | 176B00000X | LM399 | CA | Primary |
Addresses
Primary practice location
26020 Comptche-Ukiah Rd
Comptche, CA 95427
Mailing address
PO Box 165
Comptche, CA 95427
Phone (541) 727-1907
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
| License | State | Type | Specialty |
|---|---|---|---|
| LM399 | CA | MD | Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678406400000",
"number": "1992948715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 165",
"city": "COMPTCHE",
"state": "CA",
"postal_code": "95427",
"telephone_number": "541-727-1907",
"fax_number": "541-256-3772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26020 COMPTCHE-UKIAH RD",
"city": "COMPTCHE",
"state": "CA",
"postal_code": "95427",
"telephone_number": "541-727-1907",
"fax_number": "541-256-3772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENEALEY",
"first_name": "SHAUNA",
"credential": "LM, CPM, IBCLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-09",
"last_updated": "2023-03-10",
"certification_date": "2023-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "",
"desc": "Lactation Consultant, Non-RN",
"state": null,
"license": "L-22176",
"primary": false
},
{
"code": "176B00000X",
"taxonomy_group": "",
"desc": "Midwife",
"state": "CA",
"license": "LM399",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Comptche, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.