Sergio Martinez, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

041504790 Issued in IL

Practice address

12521 E High Rd
Davis Junction, IL 61020-9717

Phone

(815) 904-2332

NPI assigned

May 20, 2022

Last updated

May 20, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1740928795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12521 E HIGH RD",
            "city": "DAVIS JUNCTION",
            "state": "IL",
            "postal_code": "610209717",
            "telephone_number": "815-904-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12521 E HIGH RD",
            "city": "DAVIS JUNCTION",
            "state": "IL",
            "postal_code": "610209717",
            "telephone_number": "815-904-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "SERGIO",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041504790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "endpoint",
            "affiliation": "N",
            "address_1": "12521 E High Rd",
            "city": "Davis Junction",
            "state": "IL",
            "country_code": "US",
            "postal_code": "610209717",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Registered Nurse in Davis Junction, IL
• Providers in Davis Junction, IL by specialty
• Registered Nurse in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; 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.