Individual provider Active NPI

Emily Anne Martin, CRNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Birmingham, AL
National Provider Identifier
1184183923
Registry record updated Feb 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1-153618 Issued in AL
Practice address
2204 Lakeshore Dr Ste 440
Birmingham, AL 35209-8857
Phone
(205) 874-7844
Fax
(205) 874-7848
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-153618 AL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-153618 AL Primary

Addresses

Primary practice location

2204 Lakeshore Dr Ste 440
Birmingham, AL 35209-8857

Mailing address

2204 Lakeshore Dr Ste 440
Birmingham, AL 35209-8857
Phone (205) 874-7844

Other practice location 1

1600 7th Ave S
Birmingham, AL 35233-1711
Phone (205) 638-9175

Other names 1

  • Emily Anne Trentacoste Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20201222000512 AL Practitioner - Nurse Practitioner 9335551076 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grayson and Associates PCGroup PAC ID 9032108253, 65 clinicians

Practice addresses (Care Compare)

2200 Lakeshore Dr
Suite 150
Birmingham, AL 35209-8832
Phone (205) 871-6923

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-153618ALMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Grayson and Associates PC CurrentSince Dec 1, 2020 Accepting new patients
SVPS Psychiatric Services LLC PastSince Nov 22, 2020 Accepting new patients

Locations

2204 Lakeshore Dr
Ste 440
Homewood, AL 35209
Phone (205) 802-1094

2200 Lakeshore Dr
Ste 150
Homewood, AL 35209
Phone (205) 397-4774

100 Concourse Pkwy
Ste 101
Hoover, AL 35244
Phone (205) 444-0420

Interoperability endpoints

  • Direct secure messaging: glenwoodinc.emilytrentacostemartin@154912.advancedmd-direct.com

Organizations & group practices 2

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1184183923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 LAKESHORE DR STE 440",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352098857",
            "telephone_number": "205-874-7844",
            "fax_number": "205-874-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 LAKESHORE DR STE 440",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352098857",
            "telephone_number": "205-874-7844",
            "fax_number": "205-874-7848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 7th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331711",
            "country_code": "US",
            "telephone_number": "205-638-9175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "EMILY",
        "middle_name": "ANNE",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-153618",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-153618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "TRENTACOSTE",
            "middle_name": "ANNE",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.