Individual provider Active NPI

Maybetth Patricia Fernandez-Campos

  • Social Worker
  • Berrien Center, MI
National Provider Identifier
1427717628
Registry record updated Dec 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
6418 Deans Hill Rd
Berrien Center, MI 49102-8713
Phone
(269) 815-5500
NPI assigned
Dec 15, 2021
Last updated
Dec 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU Primary

Addresses

Primary practice location

6418 Deans Hill Rd
Berrien Center, MI 49102-8713

Mailing address

6418 Deans Hill Rd
Berrien Center, MI 49102-8713

Other names 1

  • Maybetth Martinez Other 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

NPI Registry JSON

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1427717628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6418 DEANS HILL RD",
            "city": "BERRIEN CENTER",
            "state": "MI",
            "postal_code": "491028713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6418 DEANS HILL RD",
            "city": "BERRIEN CENTER",
            "state": "MI",
            "postal_code": "491028713",
            "telephone_number": "269-815-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERNANDEZ-CAMPOS",
        "first_name": "MAYBETTH",
        "middle_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MAYBETTH",
            "last_name": "MARTINEZ",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Berrien Center, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.