Individual provider Active NPI

Robert Donald Martin, DC

  • Orthopedic Chiropractor
  • Johnston City, IL
National Provider Identifier
1043222995
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
Practice address
217 E Broadway Blvd
Johnston City, IL 62951-1604
Phone
(619) 983-3900
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL
Radiology Chiropractor 111NR0200X IL
Orthopedic Chiropractor 111NX0800X IL Primary

Addresses

Primary practice location

217 E Broadway Blvd
Johnston City, IL 62951-1604

Mailing address

217 E Broadway Blvd
P.O. Box 267
Johnston City, IL 62951-1604
Phone (618) 983-3900

Other identifiers 1

IdentifierTypeStateIssuer
073-82002OtherILBLUE CROSS/BLUE SHIELD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-005617ILMDRadiology Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1043222995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 E BROADWAY BLVD",
            "address_2": "P.O. BOX 267",
            "city": "JOHNSTON CITY",
            "state": "IL",
            "postal_code": "629511604",
            "telephone_number": "618-983-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 E BROADWAY BLVD",
            "city": "JOHNSTON CITY",
            "state": "IL",
            "postal_code": "629511604",
            "telephone_number": "619-983-3900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ROBERT",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "073-82002",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston City, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.