Individual provider Active NPI

Symontee Martin

  • Nurse's Aide
  • Wooster, OH
National Provider Identifier
1679955116
Registry record updated Jun 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
License
401085710510 Issued in OH
Practice address
324 Bardon St
Wooster, OH 44691-3604
Phone
(330) 641-9817
NPI assigned
Jun 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X 401085710510 OH Primary

Addresses

Primary practice location

324 Bardon St
Wooster, OH 44691-3604

Mailing address

324 Bardon St
Wooster, OH 44691-3604
Phone (330) 641-9817

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
401085710510OHMDNurse's Aide

NPI Registry JSON

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

{
    "created_epoch": "1434844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434844800000",
    "number": "1679955116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "324 BARDON ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913604",
            "telephone_number": "330-641-9817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 BARDON ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913604",
            "telephone_number": "330-641-9817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SYMONTEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-21",
        "last_updated": "2015-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "OH",
            "license": "401085710510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2015; 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.