Individual provider Active NPI

Martina Marie Vinson

  • Case Manager/Care Coordinator
  • Sacramento, CA
National Provider Identifier
1447898655
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
630 Bercut Dr Ste C
Sacramento, CA 95811-0110
Phone
(916) 363-1553
Fax
(916) 363-1638
NPI assigned
Dec 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

630 Bercut Dr Ste C
Sacramento, CA 95811-0110

Mailing address

1050 Fulton Ave Ste 235
Sacramento, CA 95825-4299
Phone (916) 518-3187

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": "1576627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1447898655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 FULTON AVE STE 235",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958254299",
            "telephone_number": "916-518-3187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 BERCUT DR STE C",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958110110",
            "telephone_number": "916-363-1553",
            "fax_number": "916-363-1638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VINSON",
        "first_name": "MARTINA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-18",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.

Verify at the official NPI Registry.