Individual provider Active NPI

Carolina Martinez

  • Home Health Aide
  • Pleasant Prairie, WI
National Provider Identifier
1336374131
Registry record updated May 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
374U00000X Issued in WI
Practice address
10440 55TH Ave
Pleasant Prairie, WI 53158-3401
Phone
(262) 620-5209
NPI assigned
May 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X 374U00000X WI Primary

Addresses

Primary practice location

10440 55TH Ave
Pleasant Prairie, WI 53158-3401

Mailing address

10440 55TH Ave
Pleasant Prairie, WI 53158-3401
Phone (262) 620-5209

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
374U00000XWIMDHome Health Aide

NPI Registry JSON

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

{
    "created_epoch": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242950400000",
    "number": "1336374131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10440 55TH AVE",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531583401",
            "telephone_number": "262-620-5209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10440 55TH AVE",
            "city": "PLEASANT PRAIRIE",
            "state": "WI",
            "postal_code": "531583401",
            "telephone_number": "262-620-5209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "CAROLINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-22",
        "last_updated": "2009-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "WI",
            "license": "374U00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Prairie, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2009; 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.