Kenneth Michael Martin, PT MT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT01637 Issued in LA

Practice address

2700 Lake Villa Dr Ste 100
Metairie, LA 70002-6782

Phone

(504) 888-7333

Fax

(504) 888-1052

NPI assigned

Jan 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Administrators of the Tulane Educational FundGroup PAC ID 0446163760, 388 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Medical Technician

State licenses

Practice roles

Locations

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.

• Administrators of the Tulane Educational Fund

  • Specialist
  • New Orleans, LA
  • NPI 1528014164
  Medicare reassignment Care Compare group NPD
• Administrators of the Tulane Educational Fund

  • Specialist
  • Hattiesburg, MS
  • NPI 1033395298
  NPD

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556150400000",
    "number": "1154475952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 LAKE VILLA DR STE 100",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700026782",
            "telephone_number": "504-888-7333",
            "fax_number": "504-888-1052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 LAKE VILLA DR STE 100",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700026782",
            "telephone_number": "504-888-7333",
            "fax_number": "504-888-1052"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3017 Lime St",
            "address_purpose": "LOCATION",
            "city": "Metairie",
            "state": "LA",
            "postal_code": "70006",
            "country_code": "US",
            "telephone_number": "504-888-7333",
            "fax_number": "504-888-1052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KENNETH",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "PT MT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2019-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "PT01637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "52918",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jazelin Martin
• Jennifer Bourgeios Martin, CRNA
• Joshua Martin
• Kayla Martin
• Kendra Michelle Martin
• Keontrell Keshon Martin
• Kylie Ann Martin
• Laila Martin
• Mary Louise Martin, M.D.
• Matthew Gerard Martin, NP-C

• Physical Therapist in Metairie, LA
• Providers in Metairie, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2019; 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.