Kellen Taverniti Martyn, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

201160010CRNA Issued in OR

Practice address

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970

Phone

(503) 652-2880

NPI assigned

Feb 8, 2011

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

Practice roles

Locations

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.

• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1184786527

  Nurse Anesthetist, Certified Registered

  Medicare reassignment NPD
• Kaiser Foundation Health Plan of the Northwest

  • General Practice Physician
  • Portland, OR
  • NPI 1306192455

  Nurse Anesthetist, Certified Registered

  NPD
• Kaiser Foundation Health Plan of the Northwest

  • Clinic/Center
  • Hillsboro, OR
  • NPI 1942718622
  NPD

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

{
    "created_epoch": "1297123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297382400000",
    "number": "1255637237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 SW CAMELOT CT APT 503",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972253754",
            "telephone_number": "509-475-1524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158970",
            "telephone_number": "503-652-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTYN",
        "first_name": "KELLEN",
        "middle_name": "TAVERNITI",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-08",
        "last_updated": "2011-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200541945RN",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "201160010CRNA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ali Martin, RN
• Jo M Martin, MD
• Taylor Martin, RPH
• Terri J Martin, LMT
• Melissa Martutartus
• Nada Marvin, RPH
• Whitney Headlee Marx, PA-C
• Mary T. Coleman, DC PC
• Julie Yvonne Maslen-Duvall, MPT
• Katharine M Mason-Ellis, PA-C

• Certified Registered Nurse Anesthetist in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Certified Registered Nurse Anesthetist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2011; 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.