Individual provider Active NPI

Christa D Martin, CNS

  • Clinical Nurse Specialist
  • San Angelo, TX
National Provider Identifier
1073588539
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
540682 Issued in TX
Practice address
Box 11019 Asu
1901 Johnson Street
San Angelo, TX 76909-1019
Phone
(325) 942-2171
Fax
(325) 942-2133
NPI assigned
Feb 20, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X 540682 TX Primary

Addresses

Primary practice location

Box 11019 Asu
1901 Johnson Street
San Angelo, TX 76909-1019

Mailing address

Box 11019 Asu
1901 Johnson Street
San Angelo, TX 76909-1019
Phone (325) 942-2171

Other identifiers 1

IdentifierTypeStateIssuer
176201501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Human Services Commission Clinical Nurse Specialist Past Accepting new patients

Organizations & group practices 1

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": "1140393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1073588539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BOX 11019 ASU",
            "address_2": "1901 JOHNSON STREET",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769091019",
            "telephone_number": "325-942-2171",
            "fax_number": "325-942-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BOX 11019 ASU",
            "address_2": "1901 JOHNSON STREET",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769091019",
            "telephone_number": "325-942-2171",
            "fax_number": "325-942-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CHRISTA",
        "middle_name": "D",
        "credential": "CNS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-20",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "TX",
            "license": "540682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "176201501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Angelo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.