SHIRA JOHNSON (NPI# 1477079267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477079267 |
| Entity Type | Individual |
| Full Name | SHIRA JOHNSON |
| Credential | IBCLC |
| Practice Address |
4804 Cascade Rd Se Grand Rapids MI 49546-3721 |
| Mailing Address |
2475 Sinclair Ave Ne Grand Rapids MI 49505-3602 |
| Practice Telephone | 5172815814 |
| Mailing Telephone | 5172815814 |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2017-08-14 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174N00000X | Lactation Consultant, Non-RN | L-108335 | Other Service Providers | |
| N | 174N00000X | Lactation Consultant, Non-RN | Other Service Providers |
| Street Address |
4804 CASCADE RD SE |
| City | GRAND RAPIDS |
| State | MI |
| Zip Code | 49546-3721 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437762986 | Amanda Mae Ostrom | Speech-Language Pathologist | 710 Kenmore Ave Se, #110, Grand Rapids, MI 49546 | 2020-08-25 |
| 1063075562 | Kelly Lynn Ibarra | Counselor | 4467 Cascade Road Se, Suite #4479, Grand Rapids, MI 49546 | 2019-04-19 |
| 1891257036 | Jessica Matthews LLC | Counselor | 4127 Embassy Drive Se, Grand Rapids, MI 49546 | 2019-04-05 |
| 1326518531 | Neah Morgan | Technician | 4220 Burton St Se, Grand Rapids, MI 49546 | 2018-11-29 |
| 1316430267 | Michael John Benskey | Case Manager/Care Coordinator | 4065 Saladin St Se, Grand Rapids, MI 49546 | 2018-06-14 |
| 1679062772 | Smile Cascade, P.C. | Clinic/Center | 4505 Cascade Rd Se # A, Grand Rapids, MI 49546 | 2018-05-03 |
| 1720583289 | Jeromy Krogman | Counselor | 826 Parchment Drive Se, Grand Rapids, MI 49546 | 2018-03-27 |
| 1841792660 | Affordable Hearing Clinic | Hearing Instrument Specialist | 833 Kenmoor Ave Se Ste G, Grand Rapids, MI 49546 | 2018-03-07 |
| 1689176133 | Kelly Pines | Physical Therapist | 625 Kenmoor Ave Suite 306, Grand Rapids, MI 49546 | 2018-03-01 |
| 1467971440 | Deanna Elizabeth Saenz | Social Worker | 2100 Raybrook St Se Ste 300, Grand Rapids, MI 49546 | 2017-09-12 |
| Find all providers in zip 49546 | ||||
| Taxonomy Code | 174N00000X |
| Grouping | Other Service Providers |
| Classification | Lactation Consultant, Non-RN |
| An individual trained to provide breastfeeding assistance services to both mothers and infants. Lactation Consultants are not required to be nurses and are trained through specific courses of education. The Lactation Consultant may have additional certification through a national or international organization. |
| Notes: Source: National Uniform Claim Committee [1/1/2011: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740529858 | Johanna Ellen Schnell | Lactation Consultant, Non-RN | 30672 Sunny Beach Rd, Grand Rapids, MN 55744-4891 | 2013-02-08 |
| 1508142639 | Afiya Mari-heri Orara | Lactation Consultant, Non-RN | 315 Commerce Ave Sw, Suite 419, Grand Rapids, MI 49503-4139 | 2011-11-03 |
| 1245856731 | Jennifer Hoekstra | Lactation Consultant, Non-RN | 1900 Mayberry St Se, Grand Rapids, MI 49508-1525 | 2020-06-19 |
| 1548795974 | Michele Klunder | Lactation Consultant, Non-RN | 100 Cherry St Se, Grand Rapids, MI 49503-4526 | 2017-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093274060 | Ashley Pyrc | Lactation Consultant, Non-RN | 16502 Charles Town Dr, Linden, MI 48451-9185 | 2019-03-18 |
| 1407310188 | Mistel De Varona | Lactation Consultant, Non-RN | 2149 E Napier Ave, Benton Harbor, MI 49022-1846 | 2019-01-26 |
| 1710441928 | Kirsten A Sonneville-douglass | Lactation Consultant, Non-RN | 1703 Maddy Ln, Keego Harbor, MI 48320-1156 | 2019-01-22 |
| 1497252076 | Shonte' Smith | Lactation Consultant, Non-RN | 436 S Saginaw St Ste 300, Flint, MI 48502-1830 | 2018-04-10 |
| 1477058394 | Mia Korinne Roetherford | Lactation Consultant, Non-RN | 18697 Sunderland Rd, Detroit, MI 48219-2816 | 2018-03-25 |
| 1275073744 | Gina Aiuto | Lactation Consultant, Non-RN | 18235 Marquette St, Roseville, MI 48066-3400 | 2017-03-03 |
| 1811436074 | Jennifer Day | Lactation Consultant, Non-RN | 26700 Emmett St, Southfield, MI 48033-3626 | 2017-02-20 |
| 1528501095 | Jalyn Spencer-harris | Lactation Consultant, Non-RN | 23228 Shoreview St, Saint Clair Shores, MI 48082-3020 | 2016-11-30 |
| 1902252778 | Susan L Denison | Lactation Consultant, Non-RN | 3228 Buchanan Ave Sw, Wyoming, MI 49548-2170 | 2016-05-10 |
| 1912353939 | Laura Mechele Casey-bir | Lactation Consultant, Non-RN | 10051 Farm Grove Ct Se, Caledonia, MI 49316-7715 | 2016-05-09 |
| Find all providers with the same taxonomy | ||||
| City | GRAND RAPIDS |
| Zip Code | 49546 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.