Individual provider Active NPI

Cetta Lynn Martin

  • Continuing Education/Staff Development Registered Nurse
  • Kansas City, MO
National Provider Identifier
1083422505
Registry record updated Dec 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Continuing Education/Staff Development Registered NurseTaxonomy code 163WC1600X
License
40088 Issued in KS
Practice address
4801 E Linwood Blvd
Kansas City, MO 64128-2226
Phone
(816) 861-4700
NPI assigned
Dec 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Continuing Education/Staff Development Registered Nurse 163WC1600X 40088 KS Primary

Addresses

Primary practice location

4801 E Linwood Blvd
Kansas City, MO 64128-2226

Mailing address

5285 Foxridge Dr Apt 201
Mission, KS 66202-4500

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

LicenseStateTypeSpecialty
40088KSMDHealth Service Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1735516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735516800000",
    "number": "1083422505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5285 FOXRIDGE DR APT 201",
            "city": "MISSION",
            "state": "KS",
            "postal_code": "662024500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 E LINWOOD BLVD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641282226",
            "telephone_number": "816-861-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CETTA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-30",
        "last_updated": "2024-12-30",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "KS",
            "license": "40088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2024; 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.