Jenny Anne Martin, NP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

95015446 Issued in CA

Practice address

386 14TH St
Oakland, CA 94612-3211

Phone

(415) 624-7950

NPI assigned

Apr 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Lifelong Medical Care

  • Geriatric Medicine (Family Medicine) Physician
  • Berkeley, CA
  • NPI 1689670002
  Medicare reassignment NPD
• Lifelong Medical Care

  • Family Medicine Physician
  • Rodeo, CA
  • NPI 1003289463
  NPD

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1063091619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "286 LENOX AVE APT 206",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946104608",
            "telephone_number": "415-624-7950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "386 14TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123211",
            "telephone_number": "415-624-7950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JENNY",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-04-02",
        "certification_date": "2021-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95015446",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95015446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deo Victor Martin, PHARM.D.
• Dorea E Martin, M.D.
• Gail E. Martin, MD
• Jacob Jeffrey Martin
• Jeffrey Martin, MD
• Judith Ann Martin, MD
• Katrina Martin
• Keith Martin
• Lauren Martin, LCSW
• Nathan Martin

• Primary Care Nurse Practitioner in Oakland, CA
• Providers in Oakland, CA by specialty
• Primary Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.