Individual provider Active NPI

Martha A Charles, LPN

  • Licensed Practical Nurse
  • Bastrop, LA
National Provider Identifier
1689900540
Registry record updated Oct 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
870290 Issued in LA
Practice address
9211 Collinston Rd
Bastrop, LA 71220-8703
Phone
(318) 351-0850
Fax
(318) 239-3704
NPI assigned
Oct 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 28, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 870290 LA Primary

Addresses

Primary practice location

9211 Collinston Rd
Bastrop, LA 71220-8703

Mailing address

9211 Collinston Rd
Bastrop, LA 71220-8703
Phone (318) 351-0850

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
870290LAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256688000000",
    "number": "1689900540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9211 COLLINSTON RD",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712208703",
            "telephone_number": "318-351-0850",
            "fax_number": "318-239-3704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9211 COLLINSTON RD",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712208703",
            "telephone_number": "318-351-0850",
            "fax_number": "318-239-3704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHARLES",
        "first_name": "MARTHA",
        "middle_name": "A",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2009-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "LA",
            "license": "870290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2009; 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.