Individual provider Active NPI

Marti Melinda Martin, CRNA

  • Certified Registered Nurse Anesthetist
  • Monroe, LA
National Provider Identifier
1184779431
Registry record updated Nov 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
01492 Issued in LA
Practice address
3421 Medical Park Dr.
Monroe, LA 71203
Phone
(318) 388-7890
NPI assigned
Jan 25, 2007
Last updated
Nov 6, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 01492 LA Primary

Addresses

Primary practice location

3421 Medical Park Dr.
Monroe, LA 71203

Mailing address

1687 Highway 80 E
Calhoun, LA 71225-9122
Phone (318) 397-4092

Other identifiers 1

IdentifierTypeStateIssuer
1966932MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040401000205 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6709878572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Smso Anesthesia, LLCGroup PAC ID 7012970627, 49 clinicians

Practice addresses (Care Compare)

2408 Broadmoor Blvd
Monroe, LA 71201-2994
Phone (318) 812-1760

309 Jackson St
Monroe, LA 71201-7407
Phone (318) 812-1760

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01492LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Fontenot & McIntosh, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients
Twin City Anesthesia Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: marti.martingarlingtoncrna.p1@direct.lapaincare.nextgenshare.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194307200000",
    "number": "1184779431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1687 HIGHWAY 80 E",
            "city": "CALHOUN",
            "state": "LA",
            "postal_code": "712259122",
            "telephone_number": "318-397-4092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 MEDICAL PARK DR.",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "71203",
            "telephone_number": "318-388-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MARTI",
        "middle_name": "MELINDA",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "01492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1966932",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.