Juan Martinez

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

0174955 Issued in CO

Practice address

1259 Lake Plaza Dr
Colorado Springs, CO 80906-3504

Phone

(719) 333-5804

NPI assigned

Mar 18, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Juan F Martinez-Medina Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1700279510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 WHISKEY RIVER DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809234105",
            "telephone_number": "719-432-9456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1259 LAKE PLAZA DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809063504",
            "telephone_number": "719-333-5804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "JUAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-18",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "0174955",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "CO",
            "license": "0174955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUAN",
            "last_name": "MARTINEZ-MEDINA",
            "middle_name": "F",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• J'Lyn Alexis Martinez
• Jasmine Martinez
• Jennifer Martinez, LMT
• Jesus Martinez
• Joseph Martinez
• Lea Martinez
• Leslie Martinez
• Luis Martinez
• Madiana Martinez
• Maximilliano A Martinez, PT, DPT

• Gerontology Nurse Practitioner in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Gerontology Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2024; 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.