Individual provider Active NPI

Jamie Martin, CRNA

  • Certified Registered Nurse Anesthetist
  • Pikeville, KY
National Provider Identifier
1104240639
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
3008509 Issued in KY
Practice address
911 Bypass Rd BLDG a
Pikeville, KY 41501-1689
Phone
(606) 430-3500
Fax
(606) 437-1033
NPI assigned
Feb 4, 2014
Last updated
Oct 5, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 3008509 KY Primary

Addresses

Primary practice location

911 Bypass Rd BLDG a
Pikeville, KY 41501-1689

Mailing address

PO Box 432
Pikeville, KY 41502-0432
Phone (606) 430-3500

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmartin21724@PIKEVILLEKYDIRECT.ORG Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140306000176 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 7719117076 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pikeville Medical Center IncGroup PAC ID 6709790157, 427 clinicians

Practice addresses (Care Compare)

184 S Mayo Trail
Pikeville, KY 41501-1518
Phone (606) 430-2213

911 Bypass Rd
Pikeville, KY 41501-1689

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.67 of 100Reported as group
Quality
81.47
Promoting interoperability
100
Improvement activities
40
Cost
81.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Triangle Anesthesia Group PSC Nurse Anesthetist, Certified Registered CurrentSince Jun 15, 2016 Accepting new patients
Commonwealth Anesthesia, PSC Nurse Anesthetist, Certified Registered CurrentSince May 31, 2016 Accepting new patients
Pikeville Medical Center Inc. Nurse Anesthetist, Certified Registered Current Accepting new patients
Pikeville Medical Center Inc. CurrentSince Feb 17, 2014 Accepting new patients
Pikeville Medical Center Inc CurrentSince Feb 17, 2014 Accepting new patients

Locations

100 Medical Dr
Hazard, KY 41701
Phone (606) 439-6600

310 S Limestone
Lexington, KY 40508
Phone (606) 252-6612

989 Medical Park Dr
Maysville, KY 41056
Phone (606) 759-3112

3600 Cumberland Ave
Middlesboro, KY 40965
Phone (606) 237-1700

184 S Mayo Trl
Pikeville, KY 41501
Phone (606) 430-2213

911 Bypass Rd
Pikeville, KY 41501
Phone (606) 218-4530

911 Bypass Rd
Bldg A
Pikeville, KY 41501
Phone (606) 430-2201

260 Hospital Dr
South Williamson, KY 41503
Phone (606) 237-1700

Interoperability endpoints

  • Direct secure messaging: jmartin21724@pikevillekydirect.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1391472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1104240639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 432",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415020432",
            "telephone_number": "606-430-3500",
            "fax_number": "606-437-1033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 BYPASS RD BLDG A",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415011689",
            "telephone_number": "606-430-3500",
            "fax_number": "606-437-1033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JAMIE",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-04",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3008509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmartin21724@PIKEVILLEKYDIRECT.ORG",
            "affiliation": "N",
            "endpointDescription": "Direct address for ccda",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Standard direct functionality",
            "address_1": "911 Bypass Rd Bldg A",
            "city": "Pikeville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "415011689",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pikeville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.