Individual provider Active NPI

Teresa Jean Martinez, RN

  • Registered Nurse
  • Phoenix, AZ
National Provider Identifier
1982292264
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN170902 Issued in AZ
Practice address
3620 W Ludlow Dr
Phoenix, AZ 85032-8503
Phone
(602) 908-7989
NPI assigned
Jan 4, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X RN170902 AZ Primary

Addresses

Primary practice location

3620 W Ludlow Dr
Phoenix, AZ 85032-8503

Mailing address

3620 E Ludlow Dr
Phoenix, AZ 85032-5727
Phone (602) 908-7989

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN170902AZMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1609718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1982292264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3620 E LUDLOW DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850325727",
            "telephone_number": "602-908-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3620 W LUDLOW DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850328503",
            "telephone_number": "602-908-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "TERESA",
        "middle_name": "JEAN",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-01-04",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN170902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.