Individual provider Active NPI

Amy Arbaugh Martin, MS, CRNP

  • Family Nurse Practitioner
  • Westminster, MD
National Provider Identifier
1235138793
Registry record updated Aug 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R107890 Issued in MD
Practice address
10 Distillery Rd
Suite 200
Westminster, MD 21157-5344
Phone
(410) 876-4800
Fax
(410) 871-3219
NPI assigned
Jul 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R107890 MD
Family Nurse Practitioner 363LF0000X R107890 MD Primary

Addresses

Primary practice location

10 Distillery Rd
Suite 200
Westminster, MD 21157-5344

Mailing address

3904 Grave Run Rd
Millers, MD 21102-2218
Phone (443) 536-3527

Other identifiers 1

IdentifierTypeStateIssuer
158204600MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20080218000726 MD Practitioner - Nurse Practitioner 0244313971 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cedar Ridge Counseling Centers, LLCGroup PAC ID 4981649738, 44 clinicians

Practice addresses (Care Compare)

1311 Londontown Blvd
Suite 130a
Eldersburg, MD 21784-6439
Phone (410) 552-0773

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cedar Ridge Counseling Centers LLC CurrentSince Mar 20, 2019 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2973 Manchester Rd
Manchester, MD 21102
Phone (410) 374-4747

1311 Londontown Blvd
Ste 130A
Sykesville, MD 21784
Phone (410) 356-9208

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1235138793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3904 GRAVE RUN RD",
            "city": "MILLERS",
            "state": "MD",
            "postal_code": "211022218",
            "telephone_number": "443-536-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DISTILLERY RD",
            "address_2": "SUITE 200",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575344",
            "telephone_number": "410-876-4800",
            "fax_number": "410-871-3219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "AMY",
        "middle_name": "ARBAUGH",
        "name_prefix": "Mrs.",
        "credential": "MS, CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-18",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R107890",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R107890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "158204600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

Verify at the official NPI Registry.