Individual provider Active NPI

Antoinette Marie Martin, TCADC

  • Case Manager/Care Coordinator
  • Louisville, KY
National Provider Identifier
1053008169
Registry record updated May 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
10235 Riverstone Cir
Louisville, KY 40229-5228
Phone
(502) 975-9412
NPI assigned
Apr 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X KY Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 282757 KY

Addresses

Primary practice location

10235 Riverstone Cir
Louisville, KY 40229-5228

Mailing address

4621 Outer Loop Ste 175
Louisville, KY 40219-3970
Phone (502) 431-3073

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

LicenseStateTypeSpecialty
282757KYMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Antoinette'S TCM Services LLC Case Manager/Care Coordinator CurrentSince Dec 7, 2025 Accepting new patients
Baymark Health Services of Kentucky, Inc. PastSince Apr 1, 2023 Accepting new patients

Locations

1211 W Broadway
Louisville, KY 40203
Phone (502) 410-2963

4621 Outer Loop
Louisville, KY 40219

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": "1681862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778544000000",
    "number": "1053008169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4621 OUTER LOOP STE 175",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402193970",
            "telephone_number": "502-431-3073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10235 RIVERSTONE CIR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402295228",
            "telephone_number": "502-975-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ANTOINETTE",
        "middle_name": "MARIE",
        "credential": "TCADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-19",
        "last_updated": "2026-05-12",
        "certification_date": "2026-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "KY",
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KY",
            "license": "282757",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; 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.