Individual provider Active NPI

Martha Louise Hare, DNP, RN, FNP-BC

  • Family Nurse Practitioner
  • Brenham, TX
National Provider Identifier
1073603452
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
500685 Issued in TX
Practice address
4001 Highway 36 S
Brenham, TX 77833-9610
Phone
(979) 277-1368
Fax
(979) 277-1360
NPI assigned
Oct 13, 2006
Last updated
Jul 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 500685 TX Primary

Addresses

Primary practice location

4001 Highway 36 S
Brenham, TX 77833-9610

Mailing address

909 Lakeview Lane
Somerville, TX 77879
Phone (979) 535-3000

Other identifiers 1

IdentifierTypeStateIssuer
500685OtherTXBOARD OF NURSE EXAMINERS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120413000312 TX Practitioner - Nurse Practitioner 9436310752 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
500685TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Employee Assistance Program Inc CurrentSince Mar 28, 2018 Accepting new patients
Regional Employee Assistance Program Inc CurrentSince Mar 28, 2018 Accepting new patients
Regional Employee Assistance Program Inc Current Accepting new patients

Locations

2801 Franciscan Dr
Bryan, TX 77802
Phone (409) 776-3777

711 Church Ave
Ste 101
College Station, TX 77840
Phone (979) 485-2827

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1073603452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 LAKEVIEW LANE",
            "city": "SOMERVILLE",
            "state": "TX",
            "postal_code": "77879",
            "telephone_number": "979-535-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 HIGHWAY 36 S",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778339610",
            "telephone_number": "979-277-1368",
            "fax_number": "979-277-1360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARE",
        "first_name": "MARTHA",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "DNP, RN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-13",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "500685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF NURSE EXAMINERS",
            "identifier": "500685",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

Verify at the official NPI Registry.