Individual provider Active NPI

Lynn Nicole Martin

  • Licensed Practical Nurse
  • Cleveland, OH
National Provider Identifier
1821428079
Registry record updated Nov 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN139481-M-IV Issued in OH
Practice address
2899 E 112TH St
Cleveland, OH 44104-4807
Phone
(216) 952-7782
NPI assigned
Nov 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN139481-M-IV OH Primary

Addresses

Primary practice location

2899 E 112TH St
Cleveland, OH 44104-4807

Mailing address

2899 E 112TH St
Cleveland, OH 44104-4807
Phone (216) 952-7782

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
PN139481-M-IVOHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1385251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385251200000",
    "number": "1821428079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2899 E 112TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441044807",
            "telephone_number": "216-952-7782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2899 E 112TH ST",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441044807",
            "telephone_number": "216-952-7782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LYNN",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-24",
        "last_updated": "2013-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN139481-M-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2013; 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.