Active NPI
David Clark Martinez, DC
- Chiropractor
- Mulvane, KS
National Provider Identifier
1245240175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 0104087
- Practice address
- 1100 S E Louis Blvd
Mulvane, KS 67110 - Phone
- (316) 777-9200
- Fax
- (316) 777-0393
- NPI assigned
- Aug 9, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 0104087 | KS | Primary |
Addresses
Primary practice location
1100 S E Louis Blvd
Mulvane, KS 67110
Mailing address
1100 S E Louis Blvd
Mulvane, KS 67110
Phone (316) 777-9200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4588319 | Other | KS | AETNA US HEALTHCARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0104087 | KS | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245240175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 S E LOUIS BLVD",
"city": "MULVANE",
"state": "KS",
"postal_code": "67110",
"telephone_number": "316-777-9200",
"fax_number": "316-777-0393"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 S E LOUIS BLVD",
"city": "MULVANE",
"state": "KS",
"postal_code": "67110",
"telephone_number": "316-777-9200",
"fax_number": "316-777-0393"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "DAVID",
"middle_name": "CLARK",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KS",
"license": "0104087",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA US HEALTHCARE",
"identifier": "4588319",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mulvane, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.