Active NPI
Myrna Martinez
- Skilled Nursing Facility
- Colchester, CT
National Provider Identifier
1164674925
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 000192
- Practice address
- 2 Boulder Rd
Colchester, CT 06415-2435 - Phone
- (860) 447-2957
- NPI assigned
- Oct 10, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 000192 | CT | Primary |
Addresses
Primary practice location
2 Boulder Rd
Colchester, CT 06415-2435
Mailing address
2 Boulder Rd
Colchester, CT 06415-2435
Phone (860) 447-2957
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 |
|---|---|---|---|
| 000192 | CT | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1223596800000",
"number": "1164674925",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 BOULDER RD",
"city": "COLCHESTER",
"state": "CT",
"postal_code": "064152435",
"telephone_number": "860-447-2957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 BOULDER RD",
"city": "COLCHESTER",
"state": "CT",
"postal_code": "064152435",
"telephone_number": "860-447-2957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "MYRNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-10",
"last_updated": "2008-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CT",
"license": "000192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colchester, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.