Individual provider Active NPI

Dorothy E Martin, RN

  • Registered Nurse
  • Massena, NY
National Provider Identifier
1003935420
Registry record updated May 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
469428 Issued in NY
Practice address
21 Harrowgate Commons
Massena, NY 13662-2264
Phone
(315) 764-0718
Fax
(315) 769-1893
NPI assigned
Mar 28, 2007
Last updated
May 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 469428 NY Primary

Addresses

Primary practice location

21 Harrowgate Commons
Massena, NY 13662-2264

Mailing address

80 State Highway 310
Suite 1
Canton, NY 13617-1493
Phone (315) 386-2189

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
469428NYMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
St Lawrence County PastSince Aug 5, 2002 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1003935420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 STATE HIGHWAY 310",
            "address_2": "SUITE 1",
            "city": "CANTON",
            "state": "NY",
            "postal_code": "136171493",
            "telephone_number": "315-386-2189",
            "fax_number": "315-386-2435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HARROWGATE COMMONS",
            "city": "MASSENA",
            "state": "NY",
            "postal_code": "136622264",
            "telephone_number": "315-764-0718",
            "fax_number": "315-769-1893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DOROTHY",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "469428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massena, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; 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.