Active NPI
Kaylee Martin
- Pediatrics Physician
- Oklahoma City, OK
National Provider Identifier
1003532144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 0766R
- Practice address
- 1200 Childrens Ave
Oklahoma City, OK 73104-4637 - Phone
- (405) 271-5437
- NPI assigned
- Oct 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 0766R | OK | Primary |
Addresses
Primary practice location
1200 Childrens Ave
Oklahoma City, OK 73104-4637
Mailing address
413 Woodhollow TRL
Edmond, OK 73012-4435
Phone (405) 348-3951
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240826000950 | OK | Order and Referring Only - Pediatric Medicine | 4587103320 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666137600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727049600000",
"number": "1003532144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 WOODHOLLOW TRL",
"city": "EDMOND",
"state": "OK",
"postal_code": "730124435",
"telephone_number": "405-348-3951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 CHILDRENS AVE",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731044637",
"telephone_number": "405-271-5437"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "KAYLEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-19",
"last_updated": "2024-09-23",
"certification_date": "2024-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OK",
"license": "0766R",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.