Individual provider Active NPI

Martha L Allen

  • Assisted Living Facility
  • St. Petersburg, FL
National Provider Identifier
1881998722
Registry record updated Jan 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
PN1270731 Issued in FL
Practice address
1860 46 Street South
St. Petersburg, FL 33711
Phone
(727) 565-3759
NPI assigned
Jan 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X PN1270731 FL Primary
Private Vehicle 347C00000X PN1270731 FL
Respite Care 385H00000X PN1270731 FL

Addresses

Primary practice location

1860 46 Street South
St. Petersburg, FL 33711

Mailing address

1860 46 Street South
St. Petersburg, FL 33711
Phone (727) 565-3759

Other identifiers 1

IdentifierTypeStateIssuer
691001796MedicaidFL

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
PN1270731FLMDPrivate Vehicle

NPI Registry JSON

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

{
    "created_epoch": "1294358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294358400000",
    "number": "1881998722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 46 STREET SOUTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33711",
            "telephone_number": "727-565-3759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 46 STREET SOUTH",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "33711",
            "telephone_number": "727-565-3759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "MARTHA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-07",
        "last_updated": "2011-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "FL",
            "license": "PN1270731",
            "primary": true
        },
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "FL",
            "license": "PN1270731",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "FL",
            "license": "PN1270731",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "691001796",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St. Petersburg, FL

Sources for this page

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