Individual provider Active NPI

Enitan Omowunmi Martins, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Texarkana, AR
National Provider Identifier
1093072902
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
3417 U of a Way
Texarkana, AR 71854-1419
Phone
(870) 779-6000
Fax
(870) 779-6093
NPI assigned
Apr 16, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070018381 IL
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X AR Primary

Addresses

Primary practice location

3417 U of a Way
Texarkana, AR 71854-1419

Mailing address

3417 U of a Way
Texarkana, AR 71854-1419
Phone (870) 779-6000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mowunmie@hotmail.com Health Information Exchange (HIE)
Direct Messaging Address mowunmie@hotmail.com Health Information Exchange (HIE)

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": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1093072902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 U OF A WAY",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718541419",
            "telephone_number": "870-779-6000",
            "fax_number": "870-779-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 U OF A WAY",
            "city": "TEXARKANA",
            "state": "AR",
            "postal_code": "718541419",
            "telephone_number": "870-779-6000",
            "fax_number": "870-779-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTINS",
        "first_name": "ENITAN",
        "middle_name": "OMOWUNMI",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-16",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070018381",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "AR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mowunmie@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "HEALTH INFORMATION",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3417 U Of A Way",
            "city": "Texarkana",
            "state": "AR",
            "country_code": "US",
            "postal_code": "718541419",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mowunmie@hotmail.com",
            "affiliation": "N",
            "endpointDescription": "HEALTH INFORMATION",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3417 U Of A Way",
            "city": "Texarkana",
            "state": "AR",
            "country_code": "US",
            "postal_code": "718541419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Texarkana, AR

Sources for this page

Verify at the official NPI Registry.