Martavia Stanford, LABORATORY DIRECTOR

Primary specialty

Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X

License

52D2261520 Issued in WI

Practice address

120 Bishops Way Ste 165
Brookfield, WI 53005-6249

Phone

(414) 355-5525

Fax

(414) 240-4595

NPI assigned

Oct 7, 2022

Last updated

Oct 7, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: info@careconnectionhealthsolutions.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Care Connection

  • In Home Supportive Care Agency
  • Brookfield, WI
  • NPI 1316556293
  NPD Authorized official
• Care Connection Health Solutions,LLC

  • Clinical Medical Laboratory
  • Brookfield, WI
  • NPI 1063141307
  NPD Authorized official
• Care Connection Transit

  • Non-emergency Medical Transport (VAN)
  • Brookfield, WI
  • NPI 1417860719
  NPD (past) Authorized official

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1548985930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 BISHOPS WAY STE 165",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056249",
            "telephone_number": "414-355-5525",
            "fax_number": "414-240-4595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 BISHOPS WAY STE 165",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530056249",
            "telephone_number": "414-355-5525",
            "fax_number": "414-240-4595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFORD",
        "first_name": "MARTAVIA",
        "credential": "LABORATORY DIRECTOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-07",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP1600X",
            "taxonomy_group": "",
            "desc": "Counselor, Pastoral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "372600000X",
            "taxonomy_group": "",
            "desc": "Adult Companion",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "WI",
            "license": "52D2261520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA STATE OF WISCONSIN",
            "identifier": "52D2261520",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@careconnectionhealthsolutions.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Secured Email address",
            "address_1": "120 Bishops Way Ste 165",
            "city": "Brookfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530056249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sally A Stae
• Tracy Stalter
• Jill M Stamn, PT
• Phillip Stamos, C.AC
• Stacy Stanek, OTR
• Claire T Stangl, LPC, CSAC
• Margaret Stankiewicz, SLP
• Stans Bootery Inc (Stans Fit For Your Feet)
• Deborah Marie Staszak, COTA
• Stay Strong Therapies LLC

• Clinical Laboratory Director (Non-physician) in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Clinical Laboratory Director (Non-physician) in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2022; 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.