Individual provider Active NPI

Mabel Martin Martinez, APRN-CNP

  • Family Nurse Practitioner
  • Louisville, KY
National Provider Identifier
1164315461
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4038644 Issued in KY
Practice address
4350 Brownsboro Rd Ste 200
Louisville, KY 40207-1681
Phone
(502) 244-2420
NPI assigned
Jun 3, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4038644 KY Primary

Addresses

Primary practice location

4350 Brownsboro Rd Ste 200
Louisville, KY 40207-1681

Mailing address

8306 Creek Trail CT
Louisville, KY 40291-2774
Phone (502) 295-5439

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250714003730 KY Practitioner - Nurse Practitioner 3072028570 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
360Care Services of Kentucky LLCGroup PAC ID 9931587888, 17 clinicians

Practice addresses (Care Compare)

4350 Brownsboro Rd
Suite 200
Louisville, KY 40207-1681
Phone (248) 528-2116

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4038644KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Care Health Network LLC CurrentSince Sep 1, 2025 Accepting new patients
360Care Services of Kentucky LLC CurrentSince Jun 1, 2025 Accepting new patients
360Care Services of Kentucky LLC Current Accepting new patients

Locations

9201 E Mountain View Rd
Ste 220
Scottsdale, AZ 85258
Phone (480) 862-1883

12910 Shelbyville Rd
Ste 300
Louisville, KY 40243
Phone (502) 214-0693

4350 Brownsboro Rd
Ste 210
Louisville, KY 40207
Phone (830) 212-1661

312 S 4th St
Ste 700
Louisville, KY 40202
Phone (502) 628-5023

12910 Shelbyville Rd
Ste 110
Louisville, KY 40243

4350 Brownsboro Rd
Ste 200
Louisville, KY 40207
Phone (513) 771-7483

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1748908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1164315461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8306 CREEK TRAIL CT",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402912774",
            "telephone_number": "502-295-5439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 BROWNSBORO RD STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402071681",
            "telephone_number": "502-244-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN MARTINEZ",
        "first_name": "MABEL",
        "credential": "APRN-CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-06-03",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "4038644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.