Joseph Clayton Martin, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Petersburg, IN
NPI 1073183646 · NPPES record last updated May 10, 2024
Key facts
- NPI
- 1073183646
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 71013760A (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
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Good Samaritan Family Health Center Inc
Practice addresses (Care Compare)
611 E Main St
Suite 110
Petersburg, IN 47567-1270
Phone (812) 354-8785
Hospital & facility affiliations
- Good Samaritan Hospital
- Deaconess Hospital Inc
- Memorial Hospital and Health Care Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, IN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230606003077 | IL | Practitioner - Nurse Practitioner | 2264838234 | Reassigns benefits to 1 organization |
| I20240605000760 | IN | Practitioner - Nurse Practitioner | 2264838234 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 209.027107 | IL | MD | Family Nurse Practitioner |
| 71013760A | IN | MD | Family Nurse Practitioner |
| NUR-APRN-LIC-175155 | MT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Good Samaritan Family Health Center, Inc | Current | Accepting new patients | |
| Promise Healthcare NFP | Current |
Accepting new patients | |
| Promise Healthcare NFP | Current | 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. | Current |
Accepting new patients | |
| Gibson Community Hospital Association | Past | Accepting new patients |
Locations
821 S Neil St
Champaign, IL 61820
Phone (217) 356-1558
819 Bloomington Rd
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
- jmartin221477@direct.deaconess.com
- joseph.martin.p11@direct.fhn-fqhc.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NUR-APRN-LIC-175155 | MT | |
| Family Nurse Practitioner | 363LF0000X | 209.027107 | IL | |
| Family Nurse Practitioner | 363LF0000X | 71013760A | IN | Yes |
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
Other providers in Petersburg, IN
- Hook-Superx LLC
- Michelle Igleheart
- Gary J Keepes
- Mark A Luff
- Chastidy Mader
- Toni M Martin
- Lynnette M Matteson
- Kelsey Marie Myers
- Rachael Pancake
- Pike County Area Rehabilitation Centers Inc
All providers in Petersburg, IN · Family Nurse Practitioner in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.