Individual provider Active NPI

Martin William Kinnison, MD

  • Surgery Physician
  • Fort Hood, TX
National Provider Identifier
1073580015
Registry record updated Jul 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
0101235355 Issued in VA
Practice address
36000 Darnall Loop
Carl R. Darnall Army Medical Center, General Surgery
Fort Hood, TX 76544-5095
Phone
(254) 288-8464
Fax
(254) 286-7188
NPI assigned
Mar 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 0101235355 VA Primary

Addresses

Primary practice location

36000 Darnall Loop
Carl R. Darnall Army Medical Center, General Surgery
Fort Hood, TX 76544-5095

Mailing address

36000 Darnall Loop
Carl R. Darnall Army Medical Center, General Surgery
Fort Hood, TX 76544-5095
Phone (254) 288-8464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342483200000",
    "number": "1073580015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36000 DARNALL LOOP",
            "address_2": "CARL R. DARNALL ARMY MEDICAL CENTER, GENERAL SURGERY",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445095",
            "telephone_number": "254-288-8464",
            "fax_number": "254-286-7188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36000 DARNALL LOOP",
            "address_2": "CARL R. DARNALL ARMY MEDICAL CENTER, GENERAL SURGERY",
            "city": "FORT HOOD",
            "state": "TX",
            "postal_code": "765445095",
            "telephone_number": "254-288-8464",
            "fax_number": "254-286-7188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNISON",
        "first_name": "MARTIN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2012-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101235355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Hood, TX

Sources for this page

Verify at the official NPI Registry.