Individual provider Active NPI

Keysha Ayriam Martinez-Torres, PHD, CCC-SLP

  • Speech-Language Pathologist
  • Nashville, TN
National Provider Identifier
1043717796
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
6396 Issued in TN
Practice address
326 Chamberlin St
Nashville, TN 37209-4815
Phone
(876) 468-9817
NPI assigned
Apr 10, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 6396 TN Primary

Addresses

Primary practice location

326 Chamberlin St
Nashville, TN 37209-4815

Mailing address

326 Chamberlin St
Nashville, TN 37209-4815
Phone (615) 910-6776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231013002194 TN Practitioner - Qualified Speech Language Pathologist 2668827429 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Fundamentals LLC CurrentSince Aug 2, 2023 Accepting new patients
Jackie-D-Yak, LLC Past Accepting new patients

Locations

209 Gothic Ct
Franklin, TN 37067
Phone (615) 910-6776

209 Gothic Ct
Ste 108
Franklin, TN 37067
Phone (615) 364-3934

4741 Trousdale Dr
Ste 1
Nashville, TN 37220
Phone (615) 290-5397

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1043717796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "326 CHAMBERLIN ST",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372094815",
            "telephone_number": "615-910-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "326 CHAMBERLIN ST",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372094815",
            "telephone_number": "876-468-9817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ-TORRES",
        "first_name": "KEYSHA",
        "middle_name": "AYRIAM",
        "credential": "PHD, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "6396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.