Individual provider Active NPI

Ellen Rochelle Tahhahwah-Martinez, RN

  • Medical-Surgical Registered Nurse
  • Lawton, OK
National Provider Identifier
1548785348
Registry record updated Aug 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
825561 Issued in TX
Practice address
1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002
Phone
(580) 354-5270
NPI assigned
Aug 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X 825561 TX Primary

Addresses

Primary practice location

1515 NE Lawrie Tatum Rd
Lawton, OK 73507-3002

Mailing address

1102 SW New York Ave
Lawton, OK 73501-7320
Phone (580) 678-7982

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
825561TXMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1502668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502668800000",
    "number": "1548785348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 SW NEW YORK AVE",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735017320",
            "telephone_number": "580-678-7982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 NE LAWRIE TATUM RD",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735073002",
            "telephone_number": "580-354-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAHHAHWAH-MARTINEZ",
        "first_name": "ELLEN",
        "middle_name": "ROCHELLE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-14",
        "last_updated": "2017-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "TX",
            "license": "825561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2017; 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.