Individual provider Active NPI

Martha C. Reiser, CNP

  • Adult Health Nurse Practitioner
  • Elyria, OH
National Provider Identifier
1790808574
Registry record updated May 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN137889 NP-05026 Issued in OH
Practice address
630 East River Rd
Elyria, OH 44035
Phone
(440) 326-4310
NPI assigned
Apr 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN137889 NP-05026 OH Primary
Acute Care Clinical Nurse Specialist 364SA2100X RN137889 NS-03045 OH

Addresses

Primary practice location

630 East River Rd
Elyria, OH 44035

Mailing address

842 Mildred Ave
Lorain, OH 44052-1214
Phone (440) 246-9484

Other identifiers 1

IdentifierTypeStateIssuer
2402028MedicaidOH

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)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN137889 NP-05026OHMDAdult Health Nurse Practitioner
RN137889 NS-03045OHMDAcute Care Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
DRS Russell Berkebile and Associates Inc Past Accepting new patients
Community Hospitalist, LLC PastSince May 8, 2018 Accepting new patients
North Ohio Heart Center Inc Adult Health Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304985600000",
    "number": "1790808574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 MILDRED AVE",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440521214",
            "telephone_number": "440-246-9484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 EAST RIVER RD",
            "city": "ELYRIA",
            "state": "OH",
            "postal_code": "44035",
            "telephone_number": "440-326-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISER",
        "first_name": "MARTHA",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2011-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "RN137889 NP-05026",
            "primary": true
        },
        {
            "code": "364SA2100X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "OH",
            "license": "RN137889 NS-03045",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2402028",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elyria, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2011; 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.