Individual provider Active NPI

Christina Marie Martin, CNM, WHNP

  • Women's Health Nurse Practitioner
  • Manchester, CT
National Provider Identifier
1073143392
Registry record updated Nov 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
8646 Issued in CT
Practice address
319B Main St
Manchester, CT 06040-4128
Phone
(860) 643-1607
NPI assigned
Jan 26, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 8646 CT Primary
Advanced Practice Midwife 367A00000X 462 CT

Addresses

Primary practice location

319B Main St
Manchester, CT 06040-4128

Mailing address

319B Main St
Manchester, CT 06040-4128
Phone (860) 643-1607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20230616002954 CT Practitioner - Nurse Practitioner 0840658290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Planned Parenthood of Southern New England IncGroup PAC ID 3173436730, 41 clinicians

Practice addresses (Care Compare)

345 Whitney Ave
New Haven, CT 06511-2348
Phone (203) 503-0450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Southern New England, Inc. CurrentSince May 13, 2023 Accepting new patients
Her Wellness Health Center LLC PastSince Feb 1, 2020 Accepting new patients

Locations

345 Whitney Ave
New Haven, CT 06511
Phone (203) 503-0450

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16202/brand/1/csg/1/fhir/r4

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": "1579996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1073143392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319B MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404128",
            "telephone_number": "860-643-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319B MAIN ST",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404128",
            "telephone_number": "860-643-1607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "CNM, WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-26",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "CT",
            "license": "8646",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CT",
            "license": "462",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

Verify at the official NPI Registry.