Individual provider Active NPI

Victor L Martin, CRNA

  • Certified Registered Nurse Anesthetist
  • Nashville, TN
National Provider Identifier
1245206572
Registry record updated Feb 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AANA038996 Issued in TN
Practice address
310 25TH Ave N
Nashville, TN 37203-1515
Phone
(615) 329-9023
NPI assigned
Feb 27, 2006
Last updated
Feb 10, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN53103 TN
Certified Registered Nurse Anesthetist 367500000X AANA038996 TN Primary

Addresses

Primary practice location

310 25TH Ave N
Nashville, TN 37203-1515

Mailing address

PO Box 16068
High Point, NC 27261-6068
Phone (336) 882-4615

Other identifiers 1

IdentifierTypeStateIssuer
3627837MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040618001068 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 2466437041 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN53103TNMDRegistered Nurse
AANA038996TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Stage Two Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Aug 8, 2011 Accepting new patients
Hypnos Anesthesia Services, PLLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2021 Accepting new patients
Anesthesia Medical Group, PC Nurse Anesthetist, Certified Registered Past Accepting new patients
Neurosurgical Anesthesiologist,PLC Past Accepting new patients
Upper Cumberland Anesthesia Associates, PC Nurse Anesthetist, Certified Registered PastSince Apr 19, 2020 Accepting new patients

Locations

400 10th St E
Waconia, MN 55387

1059 Neal St
Ste B
Cookeville, TN 38501
Phone (931) 646-7058

310 25th Ave N
Ste 105
Nashville, TN 37203
Phone (615) 329-9023

1024 Kelley Dr
Paris, TN 38242
Phone (731) 642-5003

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1245206572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16068",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272616068",
            "telephone_number": "336-882-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 25TH AVE N",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031515",
            "telephone_number": "615-329-9023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "VICTOR",
        "middle_name": "L",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN53103",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "AANA038996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3627837",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.