NPIMap

Individual provider Active NPI

Dodie Lane Martin, PA-C

  • Physician Assistant
  • La Crosse, KS
National Provider Identifier
1215116876
Registry record updated Dec 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
15-01190 Issued in KS
Practice address
801 Locust St
La Crosse, KS 67548-9673
Phone
(785) 222-2564
Fax
(785) 222-2868
NPI assigned
Oct 31, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 15-01190 KS Primary

Addresses

Primary practice location

801 Locust St
La Crosse, KS 67548-9673

Mailing address

PO Box 520
La Crosse, KS 67548-0520
Phone (785) 222-2564

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071208000080 KS Practitioner - Physician Assistant 4981793387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rush County Memorial HospitalGroup PAC ID 3476564840, 9 clinicians

Practice addresses (Care Compare)

801 Locust St
La Crosse, KS 67548-9673
Phone (785) 222-2564

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
15-01190KSMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rush County Memorial Hospital Past Accepting new patients
Rush County Memorial Hospital Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: dodie.martin.1@14974.direct.athenahealth.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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576627200000",
    "number": "1215116876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 520",
            "city": "LA CROSSE",
            "state": "KS",
            "postal_code": "675480520",
            "telephone_number": "785-222-2564",
            "fax_number": "785-222-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 LOCUST ST",
            "city": "LA CROSSE",
            "state": "KS",
            "postal_code": "675489673",
            "telephone_number": "785-222-2564",
            "fax_number": "785-222-2868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DODIE",
        "middle_name": "LANE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-31",
        "last_updated": "2019-12-18",
        "certification_date": "2019-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KS",
            "license": "15-01190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, KS

Sources for this page

Verify at the official NPI Registry.