Carmen Lydia Materno, ARNP

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

5011425 Issued in NC

Practice address

509 N Brightleaf Blvd
Smithfield, NC 27577-4407

Phone

(919) 784-2676

NPI assigned

May 13, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Carmen Lydia Ruiz Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1305244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566950400000",
    "number": "1588956122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 N BRIGHTLEAF BLVD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774407",
            "telephone_number": "919-784-2676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 N BRIGHTLEAF BLVD",
            "city": "SMITHFIELD",
            "state": "NC",
            "postal_code": "275774407",
            "telephone_number": "919-784-2676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5595 Ponce De Leon Blvd",
            "address_purpose": "LOCATION",
            "city": "Coral Gables",
            "state": "FL",
            "postal_code": "33146",
            "country_code": "US",
            "telephone_number": "305-661-1515",
            "fax_number": "305-662-3723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATERNO",
        "first_name": "CARMEN",
        "middle_name": "LYDIA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-13",
        "last_updated": "2019-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN0002X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Neonatal Intensive Care",
            "state": "FL",
            "license": "ARNP 2925302",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "FL",
            "license": "2925302",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "NC",
            "license": "5011425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP LICENSE",
            "identifier": "ARNP 2925302",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARMEN",
            "last_name": "RUIZ",
            "middle_name": "LYDIA",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashleigh Pappadake Martin, CPNP-PC
• Berkeley Martin
• Tabitha Lynette Martin
• Siamak Marzbani, M.D.
• Robbie Massengill, PHARM.D.
• Tuesday Mathews
• Daelyn Marie Matthews
• Laurie Mayenschein, RN
• Todd Michael Mazur, PA-C
• Ellyson Williams McBean, CCC-SLP

• Neonatal Nurse Practitioner in Smithfield, NC
• Providers in Smithfield, NC by specialty
• Neonatal Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2019; 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.