NPIMap

Organization Active NPI

Martin LM LLC

  • Adult Day Care Clinic/Center
  • Bloomington, MN
National Provider Identifier
1689867707
Registry record updated Dec 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
MARTIN LM LLC
Doing business as
Martin Luther Adult Day Program
Practice address
1401 E 100TH St
Bloomington, MN 55425-2615
Phone
(952) 948-5154
NPI assigned
Aug 22, 2007
Organization subpart
Yes
Parent organization
MARTIN LM LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 17, 2008

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

Authorized official

Name
Denver Kaufman
Title
President
Phone
(612) 371-0053

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X MN Primary

Addresses

Primary practice location

1401 E 100TH St
Bloomington, MN 55425-2615

Mailing address

1401 E 100TH St
Bloomington, MN 55425-2615
Phone (952) 948-5154

Other identifiers 1

IdentifierTypeStateIssuer
640027100MedicaidMN

Other names 1

  • Martin Luther Adult Day Program Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Martin LM LLC5 organizations share this tax ID, including this one
Part of
Martin LM LLC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229472000000",
    "number": "1689867707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 E 100TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554252615",
            "telephone_number": "952-948-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 E 100TH ST",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554252615",
            "telephone_number": "952-948-5154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARTIN LM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARTIN LM LLC",
        "enumeration_date": "2007-08-22",
        "last_updated": "2008-12-17",
        "status": "A",
        "authorized_official_last_name": "KAUFMAN",
        "authorized_official_first_name": "DENVER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "612-371-0053"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "MN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "640027100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Martin Luther Adult Day Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bloomington, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; 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.