Individual provider Active NPI

Kori Dawn Martinez, APRN-FNP

  • Family Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1053972158
Registry record updated Jun 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
56734 Issued in NM
Practice address
2301 Yale Blvd SE Ste D3
Albuquerque, NM 87106-4355
Phone
(505) 842-4433
Fax
(505) 842-4436
NPI assigned
Jun 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 56734 NM Primary

Addresses

Primary practice location

2301 Yale Blvd SE Ste D3
Albuquerque, NM 87106-4355

Mailing address

2301 Yale Blvd SE Ste D3
Albuquerque, NM 87106-4355
Phone (505) 842-4433

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
56734NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Med Flight Air Ambulance Inc Past Accepting new patients
Kori Martinez FNP, LLC. PastSince Feb 7, 2021 Accepting new patients

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": "1561680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561680000000",
    "number": "1053972158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 YALE BLVD SE STE D3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064355",
            "telephone_number": "505-842-4433",
            "fax_number": "505-842-4436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 YALE BLVD SE STE D3",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064355",
            "telephone_number": "505-842-4433",
            "fax_number": "505-842-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "KORI",
        "middle_name": "DAWN",
        "credential": "APRN-FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-06-28",
        "last_updated": "2019-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "56734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.