Active NPI
Leah Noel Martinez
- Licensed Practical Nurse
- Council Bluffs, IA
National Provider Identifier
1275237455
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- P52376
- Practice address
- 1750 W Broadway
Council Bluffs, IA 51501-3814 - Phone
- (712) 215-6588
- NPI assigned
- Mar 30, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | P52376 | IA | Primary |
Addresses
Primary practice location
1750 W Broadway
Council Bluffs, IA 51501-3814
Mailing address
3606 Ramelle Dr
Council Bluffs, IA 51501-7935
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 |
|---|---|---|---|
| P52376 | IA | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CRC Recovery, Inc. | Current | Accepting new patients |
Locations
1750 W Broadway
Council Bluffs, IA 51501
Phone (712) 215-6588
Organizations & group practices 1
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.
-
dba Council Bluffs Comprehensive Treatment Center
- Methadone Clinic
- Council Bluffs, IA
- NPI 1326689076
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680134400000",
"number": "1275237455",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3606 RAMELLE DR",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515017935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 W BROADWAY",
"city": "COUNCIL BLUFFS",
"state": "IA",
"postal_code": "515013814",
"telephone_number": "712-215-6588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "LEAH",
"middle_name": "NOEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-03-30",
"last_updated": "2023-03-30",
"certification_date": "2023-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "IA",
"license": "P52376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Council Bluffs, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.