Active NPI
Rebecca Marie Martin, RN
- Registered Nurse
- Elk River, MN
National Provider Identifier
1790230100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 236544-2
- Practice address
- 9943 165TH Ave NW
Elk River, MN 55330-6301 - Phone
- (612) 695-2283
- NPI assigned
- Aug 16, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 236544-2 | MN | Primary |
Addresses
Primary practice location
9943 165TH Ave NW
Elk River, MN 55330-6301
Mailing address
9943 165TH Ave NW
Elk River, MN 55330-6301
Phone (612) 695-2283
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 236544-2 | MN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1471305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471305600000",
"number": "1790230100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9943 165TH AVE NW",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553306301",
"telephone_number": "612-695-2283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9943 165TH AVE NW",
"city": "ELK RIVER",
"state": "MN",
"postal_code": "553306301",
"telephone_number": "612-695-2283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "REBECCA",
"middle_name": "MARIE",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-16",
"last_updated": "2016-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "MN",
"license": "236544-2",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elk River, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.