Individual provider Active NPI

Teri L Martucci, LMT, MSW

  • Specialist
  • Gainesville, FL
National Provider Identifier
1730103573
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MA 17019 Issued in FL
Practice address
4735 NW 30TH St
Gainesville, FL 32605-1121
Phone
(352) 337-2884
Fax
(352) 337-2884
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MA 17019 FL Primary

Addresses

Primary practice location

4735 NW 30TH St
Gainesville, FL 32605-1121

Mailing address

4735 NW 30TH St
Gainesville, FL 32605-1121
Phone (352) 337-2884

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
MA 17019FLMDSpecialist

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": "1334707200000",
    "number": "1730103573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4735 NW 30TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326051121",
            "telephone_number": "352-337-2884",
            "fax_number": "352-337-2884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4735 NW 30TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326051121",
            "telephone_number": "352-337-2884",
            "fax_number": "352-337-2884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTUCCI",
        "first_name": "TERI",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "LMT, MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2012-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "MA 17019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2012; 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.