Clyde Donald Martin Jr., CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4017 Issued in NC

Practice address

87 McGregor St
Ste. 1400
Manchester, NH 03102-3765

Phone

(603) 647-9325

NPI assigned

Jan 19, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• American Anesthesiology of North Carolina, PLLC

  • Certified Registered Nurse Anesthetist
  • Burlington, NC
  • NPI 1053677195

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Anesthesia Care Group PC

  • Anesthesiology Physician
  • Manchester, NH
  • NPI 1629074224
  NPD (past)
• Virginia Anesthesia and Perioperative Care Specialists LLC

  • Anesthesiology Physician
  • Newport News, VA
  • NPI 1760417281
  NPD (past)

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622764800000",
    "number": "1184604670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 S SERVICE RD STE 350",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117472358",
            "telephone_number": "865-342-8940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 MCGREGOR ST",
            "address_2": "STE. 1400",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031023765",
            "telephone_number": "603-647-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CLYDE",
        "middle_name": "DONALD",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024166498",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "4017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priscilla S. Marsicovetere, PA-C
• Brenda L Martel
• Megan McMahon Martel, APRN
• Alan Duane Martin, MA
• Amber Lynn Martin
• Ebony Martin, CRSW
• Kathleen M Martin, RD
• Kelly Ann Martin, OTR/L
• Raymond Martin II, CPHT-ADV., CSPT
• William Peter Martin, MD

• Certified Registered Nurse Anesthetist in Manchester, NH
• Providers in Manchester, NH by specialty
• Certified Registered Nurse Anesthetist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.