Individual provider Active NPI

Nicole Dushaun Martin, LPN

  • Licensed Practical Nurse
  • Cleveland, OH
National Provider Identifier
1912446089
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
161598 Issued in OH
Practice address
2641 N Moreland Blvd
Apt 4
Cleveland, OH 44120-1489
Phone
(216) 774-9027
NPI assigned
Feb 22, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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 161598 OH Primary

Addresses

Primary practice location

2641 N Moreland Blvd
Apt 4
Cleveland, OH 44120-1489

Mailing address

2641 N Moreland Blvd
Apt 4
Cleveland, OH 44120-1489
Phone (216) 774-9027

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
161598OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1912446089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2641 N MORELAND BLVD",
            "address_2": "APT 4",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201489",
            "telephone_number": "216-774-9027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2641 N MORELAND BLVD",
            "address_2": "APT 4",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441201489",
            "telephone_number": "216-774-9027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "NICOLE",
        "middle_name": "DUSHAUN",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "161598",
            "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 Feb 22, 2017; 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.