M Nicholas Martin, MD

Primary specialty

Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X

License

17782 Issued in KY

Practice address

4925 Rockwell Rd
Winchester, KY 40391-8509

Phone

(859) 744-1061

Fax

(859) 744-1062

NPI assigned

Jan 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 6

Other names 1

• Dr. Marvin N Martin Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Kentucky Bariatric, Inc

  • Obesity Medicine (Family Medicine) Physician
  • Winchester, KY
  • NPI 1003040072
  NPD (past)

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399507200000",
    "number": "1114076593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4925 ROCKWELL RD",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403918509",
            "telephone_number": "859-744-1061",
            "fax_number": "859-744-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4925 ROCKWELL RD",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403918509",
            "telephone_number": "859-744-1061",
            "fax_number": "859-744-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "M",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2014-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "17782",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "24668",
            "primary": false
        },
        {
            "code": "207QB0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Obesity Medicine",
            "state": "KY",
            "license": "17782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000045743",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISYS",
            "identifier": "64177827",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VARIABLE TAX ID",
            "identifier": "610882170",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065909137",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5910070",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAARE PALMETTO GBA",
            "identifier": "80031821",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARVIN",
            "last_name": "MARTIN",
            "middle_name": "N",
            "prefix": "DR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Ara S. Makdessian, M.D.
• Logan Jacob Mann, PA-C
• Megan Louise Manns, CSW
• Mareitha'S Place Heaven on Earth
• Cammie Martin
• Marvin E Bishop
• Mary Charlene Messner, LCSW, LLC
• John Masters, DMD
• Laura Mattern, PT
• Amanda Michele Mattingly, PTA

• Obesity Medicine (Family Medicine) Physician in Winchester, KY
• Providers in Winchester, KY by specialty
• Obesity Medicine (Family Medicine) Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.