Active NPI
Scott Christopher Martin, O.D.
- Optometrist
- Andersen Afb, GU
National Provider Identifier
1043435498
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6087T
- Practice address
- 36 Medical Group
Unit 14010
Andersen Afb, GU 96543-4010 - Phone
- (671) 366-6749
- NPI assigned
- Apr 13, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6087TG | TX | |
| Optometrist | 152W00000X | 6087T | TX | Primary |
Addresses
Primary practice location
36 Medical Group
Unit 14010
Andersen Afb, GU 96543-4010
Mailing address
36 Medical Group
Unit 14010
Andersen Afb, GU 96543-4010
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
| License | State | Type | Specialty |
|---|---|---|---|
| 6087T | TX | MD | Optometrist |
| 6087TG | TX | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1666224000000",
"number": "1043435498",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 MEDICAL GROUP",
"address_2": "UNIT 14010",
"city": "ANDERSEN AFB",
"state": "GU",
"postal_code": "965434010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 MEDICAL GROUP",
"address_2": "UNIT 14010",
"city": "ANDERSEN AFB",
"state": "GU",
"postal_code": "965434010",
"telephone_number": "671-366-6749"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "SCOTT",
"middle_name": "CHRISTOPHER",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-13",
"last_updated": "2022-10-20",
"certification_date": "2022-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "6087TG",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "6087T",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andersen Afb, GU
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.