Individual provider Active NPI

Martine Phillips

  • Nurse Practitioner
  • Davie, FL
National Provider Identifier
1043766264
Registry record updated Sep 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN9168061 Issued in FL
Practice address
2750 N. University Dr.
Davie, FL 33024-2546
Phone
(954) 804-6607
NPI assigned
Aug 28, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X APRN9168061 FL Primary

Addresses

Primary practice location

2750 N. University Dr.
Davie, FL 33024-2546

Mailing address

2131 Hollywood Blvd Ste 405
Hollywood, FL 33020-6787
Phone (954) 804-6607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201223002557 FL Practitioner - Nurse Practitioner 9830487412 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Remart Medical Consultant IncorporationGroup PAC ID 7315359536, 2 clinicians

Practice addresses (Care Compare)

2750 N University Dr
Davie, FL 33027-1413
Phone (954) 804-6607

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN9168061FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Remart Medical Consultant Incorporation Multi-Specialty CurrentSince Oct 1, 2020 Accepting new patients
Wholemind Intergrative Psychiatry LLC Past Accepting new patients

Locations

2750 N University Dr
Hollywood, FL 33024
Phone (954) 639-4866

2131 Hollywood Blvd
Ste 405
Hollywood, FL 33020
Phone (754) 777-6871

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600473600000",
    "number": "1043766264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2131 HOLLYWOOD BLVD STE 405",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330206787",
            "telephone_number": "954-804-6607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 N. UNIVERSITY DR.",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "330242546",
            "telephone_number": "954-804-6607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "MARTINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2020-09-19",
        "certification_date": "2020-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN9168061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

Verify at the official NPI Registry.