Individual provider Active NPI

Marisol Martinez

  • Clinical Social Worker
  • Las Cruces, NM
National Provider Identifier
1306285606
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
X-08180 Issued in NM
Practice address
100 W Griggs Ave
Las Cruces, NM 88001-1234
Phone
(575) 647-2800
Fax
(575) 647-2898
NPI assigned
Jun 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X X-08180 NM Primary

Addresses

Primary practice location

100 W Griggs Ave
Las Cruces, NM 88001-1234

Mailing address

100 W Griggs Ave
Las Cruces, NM 88001-1234
Phone (575) 647-2800

Other identifiers 1

IdentifierTypeStateIssuer
47043MedicaidNM

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
X-08180NMMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1306285606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W GRIGGS AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011234",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W GRIGGS AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011234",
            "telephone_number": "575-647-2800",
            "fax_number": "575-647-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "MARISOL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NM",
            "license": "X-08180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "47043",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Cruces, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.