Individual provider Active NPI

Shelby Pamela Martin

  • Diagnostic Radiology Physician
  • Iowa City, IA
National Provider Identifier
1053878348
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
RAD104707 Issued in IA
Practice address
601 Highway 6 W
Iowa City, IA 52246-2209
Phone
(319) 338-0581
NPI assigned
Feb 22, 2019
Last updated
Feb 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X RAD104707 IA Primary

Addresses

Primary practice location

601 Highway 6 W
Iowa City, IA 52246-2209

Mailing address

812 Talwrn CT
Iowa City, IA 52246-4821
Phone (319) 855-8935

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
RAD104707IAMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1550793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550793600000",
    "number": "1053878348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 TALWRN CT",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522464821",
            "telephone_number": "319-855-8935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 HIGHWAY 6 W",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522462209",
            "telephone_number": "319-338-0581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHELBY",
        "middle_name": "PAMELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-22",
        "last_updated": "2019-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "RAD104707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2019; 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.