Brent A Martin, APNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

8290 Issued in WI

Practice address

2809 N Park Drive LN
Appleton, WI 54911-1603

Phone

(920) 380-4999

Fax

(920) 380-4961

NPI assigned

Jan 11, 2018

Last updated

Mar 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: bmartin185942@direct.thedacare.org

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521158400000",
    "number": "1265940365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E COLLEGE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115794",
            "telephone_number": "920-996-3264",
            "fax_number": "920-830-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 N PARK DRIVE LN",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549111603",
            "telephone_number": "920-380-4999",
            "fax_number": "920-380-4961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BRENT",
        "middle_name": "A",
        "credential": "APNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-11",
        "last_updated": "2018-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "8290",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "201119",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen J Marquis, MD
• Rebecca Lynne Marrazzo, LPC, SACIT
• Jennifer M Marshall, PAC
• Kay Ellen Marsicek, BSN
• Anna Kristin Martel-Arquette, P.T.
• Craig Joseph Martin, DC
• Don Jordan Martin, MD
• Heather Marie Martin, SAC-IT
• Jacqueline Kristine Martin, SLP
• Samantha Martin, APSW

• Family Nurse Practitioner in Appleton, WI
• Providers in Appleton, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.