Individual provider Active NPI

Martha W Clinton, NP

  • Family Nurse Practitioner
  • Sevierville, TN
National Provider Identifier
1245237726
Registry record updated Jul 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN5122 Issued in TN
Practice address
208 Prince St
Sevierville, TN 37862-3821
Phone
(865) 774-7481
Fax
(865) 908-2455
NPI assigned
Jun 30, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2011

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 APN5122 TN Primary

Addresses

Primary practice location

208 Prince St
Sevierville, TN 37862-3821

Mailing address

208 Prince St
Sevierville, TN 37862-3821
Phone (865) 774-7481

Other identifiers 1

IdentifierTypeStateIssuer
3346980MedicaidTN

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050222000037 TN Practitioner - Nurse Practitioner 0244203867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN5122TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
J&J Medical PLLC Family CurrentSince Jun 28, 2023 Accepting new patients

Locations

208 Prince St
Sevierville, TN 37862
Phone (865) 774-7481

Interoperability endpoints

  • Direct secure messaging: martha.clinton.1@24739.direct.athenahealth.com

Organizations & group practices 1

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309996800000",
    "number": "1245237726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 PRINCE ST",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378623821",
            "telephone_number": "865-774-7481",
            "fax_number": "865-908-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 PRINCE ST",
            "city": "SEVIERVILLE",
            "state": "TN",
            "postal_code": "378623821",
            "telephone_number": "865-774-7481",
            "fax_number": "865-908-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLINTON",
        "first_name": "MARTHA",
        "middle_name": "W",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2011-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN5122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3346980",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sevierville, TN

Sources for this page

Verify at the official NPI Registry.