Laurel Martin, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

26923 Issued in TN

Practice address

6784 Highway 411
Benton, TN 37307-4818

Phone

(423) 338-8995

NPI assigned

Jan 28, 2020

Last updated

Jan 28, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

• Kaful Double Portion Family Practice, Inc

  • Family Nurse Practitioner
  • Cleveland, TN
  • NPI 1386049476
  Medicare reassignment NPD

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

{
    "created_epoch": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1205467339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6784 HIGHWAY 411",
            "city": "BENTON",
            "state": "TN",
            "postal_code": "373074818",
            "telephone_number": "423-338-8995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6784 HIGHWAY 411",
            "city": "BENTON",
            "state": "TN",
            "postal_code": "373074818",
            "telephone_number": "423-338-8995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LAUREL",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "26923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Matthew Gager
• Ked Consulting, LLC
• Andy Kim, DDS
• Victoria L Kinsey, DO
• Aleksander Ivanovich Malakhov, M.D.
• Denise Renee McCluskey, FNP-C
• Priscilla Inez McKnight, RN
• Charlie Mitchell
• Tonya Morgan, FNP-BC
• Jason Dewayne Nicholson, DDS

• Family Nurse Practitioner in Benton, TN
• Providers in Benton, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.