Individual provider Active NPI

Martha Cecilia Jaramillo, N.P

  • Women's Health Nurse Practitioner
  • Miami, FL
National Provider Identifier
1679596001
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
ARNP9461221 Issued in FL
Practice address
1350 NW 14TH St Ste 212
Miami, FL 33125-1609
Phone
(305) 575-5045
NPI assigned
Jul 26, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X NP130879 GA
Women's Health Nurse Practitioner 363LW0102X ARNP9461221 FL Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X NP130879 GA

Addresses

Primary practice location

1350 NW 14TH St Ste 212
Miami, FL 33125-1609

Mailing address

1350 NW 14TH St Ste 212
Miami, FL 33125-1609
Phone (305) 575-5045

Other practice location 1

3780 Holcomb Bridge Rd
Norcross, GA 30092-2701
Phone (770) 246-4446

Other identifiers 1

IdentifierTypeStateIssuer
1679596001MedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101101000568 GA Practitioner - Nurse Practitioner 9032303342 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9461221FLMDWomen's Health Nurse Practitioner
NP130879GAMDObstetrics & Gynecology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Northside Surgical Professional Services LLC CurrentSince May 1, 2011 Accepting new patients

Locations

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

1000 Johnson Fy Rd NE
Sandy Springs, GA 30342
Phone (404) 851-1000

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1679596001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 NW 14TH ST STE 212",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251609",
            "telephone_number": "305-575-5045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 NW 14TH ST STE 212",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331251609",
            "telephone_number": "305-575-5045"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3780 Holcomb Bridge Rd",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300922701",
            "country_code": "US",
            "telephone_number": "770-246-4446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JARAMILLO",
        "first_name": "MARTHA",
        "middle_name": "CECILIA",
        "name_prefix": "Ms.",
        "credential": "N.P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "NP130879",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "ARNP9461221",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "GA",
            "license": "NP130879",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679596001",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.