Individual provider Active NPI

Michael Lloyd Martin, CP,LP

  • Prosthetist
  • Oklahoma City, OK
National Provider Identifier
1104181817
Registry record updated Jul 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
LP30 Issued in OK
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

Updated by the provider on Jul 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
LP30OtherOKOKLAHOMA BOARD OF MEDICAL LICENSURE & SUPERVISION FOR ORTHOTICS & PROSTHETICS
CP2599OtherAMERICAN 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

LicenseStateTypeSpecialty
LP30OKMDProsthetist

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.

Verify at the official NPI Registry.