Martha L Coventry

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3069 Issued in WI

Practice address

10539 Applewood Road
Sister Bay, WI 54234

Phone

(920) 854-4154

NPI assigned

Mar 15, 2007

Last updated

Dec 15, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cordial Care Corporation

  dba Hearthside

  • Assisted Living Facility
  • Sister Bay, WI
  • NPI 1861616625
  Authorized official Same address or phone

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292371200000",
    "number": "1992839641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 104",
            "city": "ELLISON BAY",
            "state": "WI",
            "postal_code": "542100104",
            "telephone_number": "920-493-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10539 APPLEWOOD ROAD",
            "city": "SISTER BAY",
            "state": "WI",
            "postal_code": "54234",
            "telephone_number": "920-854-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COVENTRY",
        "first_name": "MARTHA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2010-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "3069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassaundra N Bratz, LPC
• Susan Carol Brozek, LCSW
• Rachael Anne Chomeau, PTA
• Cliffside Dental, LLC
• Cordial Care Corporation (Hearthside)
• Courtney Rheins Curry, APNP
• Jack Patrick Dooley, DDS
• Door County Memorial Hospital (Door County Medical Center Sister Bay Remote Dispensing Site)
• Door County Memorial Hospital (Door County Medical Center Sister Bay)
• Kelly C Fagundes, PT

• Family Nurse Practitioner in Sister Bay, WI
• Providers in Sister Bay, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; 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.