Individual provider Active NPI

Cynthia (Cindy) M Martin, RN

  • Registered Nurse
  • Aztec, NM
National Provider Identifier
1164029252
Registry record updated Oct 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
R34985 Issued in NM
Practice address
401 Rio Pecos Rd
Aztec, NM 87410-1646
Phone
(505) 334-2621
Fax
(505) 599-4391
NPI assigned
Oct 2, 2020
Last updated
Oct 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2020

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 R34985 NM Primary

Addresses

Primary practice location

401 Rio Pecos Rd
Aztec, NM 87410-1646

Mailing address

Exceptional Program Office, 1118 W. Aztec Blvd.
Aztec, NM 87410
Phone (505) 334-3695

Other practice location 1

455 N Light Plant Rd
Aztec, NM 87410-1517
Phone (505) 334-6102

Other practice location 2

1180 W Aztec Blvd
Aztec, NM 87410-1818
Phone (505) 334-9474

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
R34985NMMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1601596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1164029252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EXCEPTIONAL PROGRAM OFFICE, 1118 W. AZTEC BLVD.",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "87410",
            "telephone_number": "505-334-3695",
            "fax_number": "505-599-4388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 RIO PECOS RD",
            "city": "AZTEC",
            "state": "NM",
            "postal_code": "874101646",
            "telephone_number": "505-334-2621",
            "fax_number": "505-599-4391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 N Light Plant Rd",
            "address_purpose": "LOCATION",
            "city": "Aztec",
            "state": "NM",
            "postal_code": "874101517",
            "country_code": "US",
            "telephone_number": "505-334-6102",
            "fax_number": "505-599-4385",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1180 W Aztec Blvd",
            "address_purpose": "LOCATION",
            "city": "Aztec",
            "state": "NM",
            "postal_code": "874101818",
            "country_code": "US",
            "telephone_number": "505-334-9474",
            "fax_number": "505-334-9861",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CYNTHIA (CINDY)",
        "middle_name": "M",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-02",
        "last_updated": "2020-10-02",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "R34985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aztec, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.