Individual provider Active NPI

Joseph Clayton Martin, FNP-C

  • Family Nurse Practitioner
  • Petersburg, IN
National Provider Identifier
1073183646
Registry record updated May 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71013760A Issued in IN
Practice address
611 E Main St Ste 110
Petersburg, IN 47567-1270
Phone
(812) 354-8785
Fax
(812) 354-8786
NPI assigned
Jun 28, 2021
Last updated
May 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NUR-APRN-LIC-175155 MT
Family Nurse Practitioner 363LF0000X 209.027107 IL
Family Nurse Practitioner 363LF0000X 71013760A IN Primary

Addresses

Primary practice location

611 E Main St Ste 110
Petersburg, IN 47567-1270

Mailing address

280 E Jingle Bell LN
Santa Claus, IN 47579-6083
Phone (812) 608-0245

Other practice location 1

819 Bloomington Rd
Champaign, IL 61820-2101
Phone (217) 356-1558

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230606003077 IL Practitioner - Nurse Practitioner 2264838234 Reassigns benefits to 1 organization
I20240605000760 IN Practitioner - Nurse Practitioner 2264838234 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

611 E Main St
Suite 110
Petersburg, IN 47567-1270
Phone (812) 354-8785

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
209.027107ILMDFamily Nurse Practitioner
71013760AINMDFamily Nurse Practitioner
NUR-APRN-LIC-175155MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Good Samaritan Family Health Center, Inc. CurrentSince May 13, 2024 Accepting new patients
Promise Healthcare NFP CurrentSince Apr 25, 2023 Accepting new patients
Good Samaritan Family Health Center, Inc Current Accepting new patients
Promise Healthcare NFP Current Accepting new patients
Good Samaritan Family Health Center, Inc. CurrentSince May 13, 2024 Accepting new patients
Promise Healthcare NFP CurrentSince Apr 25, 2023 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

819 Bloomington Rd
Champaign, IL 61820
Phone (217) 356-1558

821 S Neil St
Champaign, IL 61820
Phone (217) 356-1558

611 E Main St
Ste 110
Petersburg, IN 47567
Phone (812) 354-8426

1027 Washington Ave
Vincennes, IN 47591
Phone (812) 494-7500

1027 Washington Ave
#B
Vincennes, IN 47591
Phone (812) 494-7500

515 Bayou St
Vincennes, IN 47591
Phone (812) 886-0907

2007 State St
Washington, IN 47501
Phone (812) 254-1558

Interoperability endpoints

  • Direct secure messaging: jmartin221477@direct.deaconess.com
  • Direct secure messaging: joseph.martin.p11@direct.fhn-fqhc.nextgenshare.com

Organizations & group practices 7

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1624838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715299200000",
    "number": "1073183646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 E JINGLE BELL LN",
            "city": "SANTA CLAUS",
            "state": "IN",
            "postal_code": "475796083",
            "telephone_number": "812-608-0245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 E MAIN ST STE 110",
            "city": "PETERSBURG",
            "state": "IN",
            "postal_code": "475671270",
            "telephone_number": "812-354-8785",
            "fax_number": "812-354-8786"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "819 Bloomington Rd",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618202101",
            "country_code": "US",
            "telephone_number": "217-356-1558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOSEPH",
        "middle_name": "CLAYTON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-28",
        "last_updated": "2024-05-10",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-175155",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.027107",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71013760A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, IN

Sources for this page

Verify at the official NPI Registry.