Active NPI
Christina Clark Martin, R.D.N.
- Registered Dietitian
- Ponchatoula, LA
National Provider Identifier
1104223833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2548
- Practice address
- 146 W Oak St
Ponchatoula, LA 70454-3329 - Phone
- (318) 614-9516
- NPI assigned
- Nov 24, 2014
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2548 | LA | Primary |
Addresses
Primary practice location
146 W Oak St
Ponchatoula, LA 70454-3329
Mailing address
PO Box 2102
Ponchatoula, LA 70454-2102
Phone (318) 614-9516
Other practice location 1
15748 Medical Arts Dr
Hammond, LA 70403-1446
Phone (985) 542-0663 ext. 2039
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 |
|---|---|---|---|
| 2548 | LA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1665532800000",
"number": "1104223833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2102",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "704542102",
"telephone_number": "318-614-9516"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "146 W OAK ST",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "704543329",
"telephone_number": "318-614-9516"
}
],
"practiceLocations": [
{
"address_1": "15748 Medical Arts Dr",
"address_purpose": "LOCATION",
"city": "Hammond",
"state": "LA",
"postal_code": "704031446",
"country_code": "US",
"telephone_number": "985-542-0663 x2039",
"fax_number": "985-318-1755",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MARTIN",
"first_name": "CHRISTINA",
"middle_name": "CLARK",
"credential": "R.D.N.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-11-24",
"last_updated": "2022-10-12",
"certification_date": "2022-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "LA",
"license": "2548",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ponchatoula, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.