Individual provider Active NPI

Martine Marie Paterra, LPN

  • Licensed Vocational Nurse
  • Fort Myers, FL
National Provider Identifier
1497325146
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
PN5249301 Issued in FL
Practice address
11848 Bayport LN Apt 2
Fort Myers, FL 33908-3800
Phone
(949) 554-5756
NPI assigned
Jun 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN5429301 FL
Licensed Vocational Nurse 164X00000X PN5249301 FL Primary

Addresses

Primary practice location

11848 Bayport LN Apt 2
Fort Myers, FL 33908-3800

Mailing address

11848 Bayport LN Apt 2
Fort Myers, FL 33908-3800
Phone (949) 554-5756

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
PN5429301FLMDLicensed Practical Nurse
PN5249301FLMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1624579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1497325146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11848 BAYPORT LN APT 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083800",
            "telephone_number": "949-554-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11848 BAYPORT LN APT 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083800",
            "telephone_number": "949-554-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATERRA",
        "first_name": "MARTINE",
        "middle_name": "MARIE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-25",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "FL",
            "license": "PN5429301",
            "primary": false
        },
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "FL",
            "license": "PN5249301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.