Individual provider Active NPI

Daniel Nicholas Mortimore, LVN

  • Licensed Vocational Nurse
  • Martinez, CA
National Provider Identifier
1831946805
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Vocational NurseTaxonomy code 164X00000X
License
276234 Issued in CA
Practice address
25 Allen Street Martinez, Ca 94553
Martinez, CA 94513
Phone
(925) 353-6841
NPI assigned
May 6, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Vocational Nurse 164X00000X 276234 CA Primary

Addresses

Primary practice location

25 Allen Street Martinez, Ca 94553
Martinez, CA 94513

Mailing address

25 Allen Street
Martinez, CA 94553
Phone (925) 353-6841

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
276234CAMDLicensed Vocational Nurse

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1831946805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ALLEN STREET",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "94553",
            "telephone_number": "925-353-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 ALLEN STREET MARTINEZ, CA 94553",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "94513",
            "telephone_number": "925-353-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTIMORE",
        "first_name": "DANIEL",
        "middle_name": "NICHOLAS",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-06-07",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "CA",
            "license": "276234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinez, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.