Individual provider Active NPI

Traci Martin, APRN, CNM

  • Advanced Practice Midwife
  • Shenandoah, TX
National Provider Identifier
1164889010
Registry record updated Feb 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
AP130075 Issued in TX
Practice address
8845 Six Pines Dr
Shenandoah, TX 77380-2675
Phone
(281) 844-2814
NPI assigned
Jan 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X AP130075 TX Primary

Addresses

Primary practice location

8845 Six Pines Dr
Shenandoah, TX 77380-2675

Mailing address

3209 Louis Rd
Crosby, TX 77532-6406
Phone (281) 844-2814

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240410002917 TX Practitioner - Certified Nurse Midwife (CNM) 9830537760 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
AP130075TXMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg Texas Holdings, P.a. CurrentSince Jul 27, 2024 Accepting new patients

Locations

777 Lowndes Hill Rd
Bldg 1
Greenville, SC 29607
Phone (864) 908-3736

12221 N Mopac Expy
Austin, TX 78758
Phone (512) 901-2530

4401 Garth Rd
Baytown, TX 77521
Phone (281) 420-8500

2830 Calder St
Beaumont, TX 77702
Phone (409) 899-7000

5950 Saratoga Blvd
Corpus Christi, TX 78414
Phone (321) 917-9263

9440 Poppy Dr
Dallas, TX 75218
Phone (214) 324-6100

1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

Organizations & group practices 1

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": "1453507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518739200000",
    "number": "1164889010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3209 LOUIS RD",
            "city": "CROSBY",
            "state": "TX",
            "postal_code": "775326406",
            "telephone_number": "281-844-2814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8845 SIX PINES DR",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773802675",
            "telephone_number": "281-844-2814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TRACI",
        "credential": "APRN, CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-23",
        "last_updated": "2018-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "AP130075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.