Individual provider Active NPI

Camelia Martin, DNP, FNP-BC

  • Family Nurse Practitioner
  • Glendale, AZ
National Provider Identifier
1245855048
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
240298 Issued in AZ
Practice address
6338 W Port Royale LN
Glendale, AZ 85306-3260
Phone
(623) 302-6460
NPI assigned
Jun 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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 240298 AZ Primary

Addresses

Primary practice location

6338 W Port Royale LN
Glendale, AZ 85306-3260

Mailing address

6338 W Port Royale LN
Glendale, AZ 85306-3260
Phone (623) 302-6460

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20200724000945 AZ Practitioner - Nurse Practitioner 2769805308 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Refocus Medical LLC Current Accepting new patients
American Premier Palliative, LLC CurrentSince Aug 1, 2020 Accepting new patients

Locations

11070 N 24th Ave
Ste 250
Phoenix, AZ 85029
Phone (602) 795-8795

11070 N 24th Ave
Phoenix, AZ 85029
Phone (520) 426-6030

Interoperability endpoints

  • Direct secure messaging: camelia.martin@999544259149828.direct.elationemr.com
  • Direct secure messaging: camelia.martin@78667879677956.direct.elationemr.com

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": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592784000000",
    "number": "1245855048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6338 W PORT ROYALE LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063260",
            "telephone_number": "623-302-6460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6338 W PORT ROYALE LN",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853063260",
            "telephone_number": "623-302-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CAMELIA",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "240298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, AZ

Sources for this page

Verify at the official NPI Registry.