Individual provider Active NPI

Stuart Martin, M.D.

  • Addiction Medicine (Internal Medicine) Physician
  • Lexington, KY
National Provider Identifier
1093707564
Registry record updated Apr 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
21427 Issued in KY
Practice address
2375 Professional Heights Dr
Suite 210
Lexington, KY 40503-3040
Phone
(859) 317-9159
Fax
(859) 309-0277
NPI assigned
Aug 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 21427 KY
Addiction Medicine (Internal Medicine) Physician 207RA0401X 21427 KY Primary

Addresses

Primary practice location

2375 Professional Heights Dr
Suite 210
Lexington, KY 40503-3040

Mailing address

4 Waters Edge PL
Lexington, KY 40502-2612
Phone (859) 266-5604

Other identifiers 1

IdentifierTypeStateIssuer
64214273MedicaidKY

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21427KYMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Central Kentucky Anesthesia PSC Anesthesiology Past Accepting new patients
Central Kentucky Anesthesia P.S.C. Past Accepting new patients
Medical Heights Surgery Center, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397174400000",
    "number": "1093707564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WATERS EDGE PL",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405022612",
            "telephone_number": "859-266-5604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 PROFESSIONAL HEIGHTS DR",
            "address_2": "SUITE 210",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405033040",
            "telephone_number": "859-317-9159",
            "fax_number": "859-309-0277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "STUART",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2014-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "KY",
            "license": "21427",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "KY",
            "license": "21427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64214273",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; 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.