Individual provider Active NPI

Joanne Ryan Martin, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Stony Point, NY
National Provider Identifier
1194995985
Registry record updated Mar 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4009003 Issued in NY
Practice address
27 Liberty Square Mall
Stony Point, NY 10980-2400
Phone
(845) 429-6900
Fax
(845) 429-7050
NPI assigned
Mar 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 381468 NY
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4009003 NY Primary

Addresses

Primary practice location

27 Liberty Square Mall
Stony Point, NY 10980-2400

Mailing address

27 Liberty Square Mall
Stony Point, NY 10980-2400
Phone (845) 429-6900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20040410000091 NY Practitioner - Nurse Practitioner 1153315452 Practice locations: Stony Point, NY

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4009003NYMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204848000000",
    "number": "1194995985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 LIBERTY SQUARE MALL",
            "city": "STONY POINT",
            "state": "NY",
            "postal_code": "109802400",
            "telephone_number": "845-429-6900",
            "fax_number": "845-429-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 LIBERTY SQUARE MALL",
            "city": "STONY POINT",
            "state": "NY",
            "postal_code": "109802400",
            "telephone_number": "845-429-6900",
            "fax_number": "845-429-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOANNE",
        "middle_name": "RYAN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-07",
        "last_updated": "2008-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "381468",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "4009003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Point, NY

Sources for this page

Verify at the official NPI Registry.