Individual provider Active NPI

Keshia Martin

  • Family Nurse Practitioner
  • Boynton Beach, FL
National Provider Identifier
1205547312
Registry record updated Dec 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11018351 Issued in FL
Practice address
11231 Green Lake Dr Apt 201
Boynton Beach, FL 33437-1432
Phone
(561) 574-4494
NPI assigned
Dec 9, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11018351 FL Primary

Addresses

Primary practice location

11231 Green Lake Dr Apt 201
Boynton Beach, FL 33437-1432

Mailing address

11231 Green Lake Dr Apt 201
Boynton Beach, FL 33437-1432
Phone (561) 574-4494

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
APRN11018351FLMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1205547312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11231 GREEN LAKE DR APT 201",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334371432",
            "telephone_number": "561-574-4494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11231 GREEN LAKE DR APT 201",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334371432",
            "telephone_number": "561-574-4494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KESHIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11018351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.