Active NPI
Michael Lloyd Martin, CP,LP
- Prosthetist
- Oklahoma City, OK
National Provider Identifier
1104181817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- License
- LP30
- Practice address
- 4301 N Classen Blvd
Oklahoma City, OK 73118-5031 - Phone
- (405) 525-4000
- Fax
- (405) 530-3670
- NPI assigned
- Jul 9, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetist | 224P00000X | LP30 | OK | Primary |
Addresses
Primary practice location
4301 N Classen Blvd
Oklahoma City, OK 73118-5031
Mailing address
4301 N Classen Blvd
Oklahoma City, OK 73118-5031
Phone (405) 525-4000
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LP30 | Other | OK | OKLAHOMA BOARD OF MEDICAL LICENSURE & SUPERVISION FOR ORTHOTICS & PROSTHETICS |
| CP2599 | Other | AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS & PROSTHETICS |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP30 | OK | MD | Prosthetist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341792000000",
"number": "1104181817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4301 N CLASSEN BLVD",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731185031",
"telephone_number": "405-525-4000",
"fax_number": "405-530-3670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 N CLASSEN BLVD",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731185031",
"telephone_number": "405-525-4000",
"fax_number": "405-530-3670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MICHAEL",
"middle_name": "LLOYD",
"name_prefix": "Mr.",
"credential": "CP,LP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-07-09",
"last_updated": "2012-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "OK",
"license": "LP30",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OKLAHOMA BOARD OF MEDICAL LICENSURE & SUPERVISION FOR ORTHOTICS & PROSTHETICS",
"identifier": "LP30",
"state": "OK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS & PROSTHETICS",
"identifier": "CP2599",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.