Individual provider Active NPI

Mary Margaret Medina, RN

  • Registered Nurse
  • Camp Pendleton, CA
National Provider Identifier
1205035839
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
333354 Issued in CA
Practice address
Naval Hospital Camp Pendleton
Building H-100 Santa Margarita Road
Camp Pendleton, CA 92055-1515
Phone
(760) 725-1344
NPI assigned
Jul 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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 333354 CA Primary

Addresses

Primary practice location

Naval Hospital Camp Pendleton
Building H-100 Santa Margarita Road
Camp Pendleton, CA 92055-1515

Mailing address

2780 Berkeley Avenue
Carlsbad, CA 92010-7919
Phone (760) 720-9218

Other names 1

  • Mary Margaret McDonald Former name

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
333354CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1205035839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2780 BERKELEY AVENUE",
            "city": "CARLSBAD",
            "state": "CA",
            "postal_code": "920107919",
            "telephone_number": "760-720-9218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "NAVAL HOSPITAL CAMP PENDLETON",
            "address_2": "BUILDING H-100 SANTA MARGARITA ROAD",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920551515",
            "telephone_number": "760-725-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "MARY",
        "middle_name": "MARGARET",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "333354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "MCDONALD",
            "middle_name": "MARGARET",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Camp Pendleton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.