Individual provider Active NPI

Kimberly B Martin, M.D.

  • Pediatrics Physician
  • Corpus Christi, TX
National Provider Identifier
1053513408
Registry record updated Oct 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
N3869 Issued in TX
Practice address
5945 Saratoga Blvd
Suite C
Corpus Christi, TX 78414-4225
Phone
(361) 853-3222
Fax
(361) 980-3619
NPI assigned
Jun 5, 2007
Last updated
Oct 28, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X N3869 TX Primary

Addresses

Primary practice location

5945 Saratoga Blvd
Suite C
Corpus Christi, TX 78414-4225

Mailing address

3533 S Alameda St
Ste. 303
Corpus Christi, TX 78411-1721
Phone (361) 853-3222

Other identifiers 2

IdentifierTypeStateIssuer
N3869OtherTXMEDICAL LICENSE
285350901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110926000335 TX Practitioner - Pediatric Medicine 2163693011 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N3869TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Abc Pediatrics, P.a. Pediatrics CurrentSince Aug 15, 2011 Accepting new patients

Locations

3533 S Alameda St
#303J
Corpus Christi, TX 78411
Phone (361) 853-3222

3533 S Alameda St
Ste 303
Corpus Christi, TX 78411
Phone (361) 853-3222

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13003/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477612800000",
    "number": "1053513408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 S ALAMEDA ST",
            "address_2": "STE. 303",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111721",
            "telephone_number": "361-853-3222",
            "fax_number": "361-561-2692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5945 SARATOGA BLVD",
            "address_2": "SUITE C",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784144225",
            "telephone_number": "361-853-3222",
            "fax_number": "361-980-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KIMBERLY",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2016-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "N3869",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "N3869",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "285350901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.