Individual provider Active NPI

Paulette Gonzalez Martin, FNP

  • Family Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1205206836
Registry record updated Jan 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
243970 Issued in NC
Practice address
10880 Durant Rd Ste 215
Raleigh, NC 27614-6629
Phone
(919) 205-4410
NPI assigned
Sep 24, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 243970 NC Primary

Addresses

Primary practice location

10880 Durant Rd Ste 215
Raleigh, NC 27614-6629

Mailing address

1316 Cornell PL
Raleigh, NC 27607-6024
Phone (954) 410-3334

Other names 1

  • Paulette Milagros Gonzalez 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

State licenses

LicenseStateTypeSpecialty
243970NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Durant Road Pediatrics PastSince Sep 4, 2022 Accepting new patients
Kidz Pediatrics, PA Past Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1443052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579046400000",
    "number": "1205206836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 CORNELL PL",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076024",
            "telephone_number": "954-410-3334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10880 DURANT RD STE 215",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276146629",
            "telephone_number": "919-205-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PAULETTE",
        "middle_name": "GONZALEZ",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-24",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "243970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAULETTE",
            "last_name": "GONZALEZ",
            "middle_name": "MILAGROS",
            "credential": "FNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.