Individual provider Active NPI

Rebecca R. Martin, RN

  • Registered Nurse
  • Owensboro, KY
National Provider Identifier
1275818379
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
1074301 Issued in KY
Practice address
2831 New Hartford Rd
Ridgecrest Medical Park
Owensboro, KY 42303-1320
Phone
(270) 926-4100
Fax
(270) 684-4678
NPI assigned
Oct 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1074301 KY Primary

Addresses

Primary practice location

2831 New Hartford Rd
Ridgecrest Medical Park
Owensboro, KY 42303-1320

Mailing address

2831 New Hartford Rd
Ridgecrest Medical Park
Owensboro, KY 42303-1320
Phone (270) 926-4100

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
1074301KYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1275818379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 NEW HARTFORD RD",
            "address_2": "RIDGECREST MEDICAL PARK",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031320",
            "telephone_number": "270-926-4100",
            "fax_number": "270-684-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 NEW HARTFORD RD",
            "address_2": "RIDGECREST MEDICAL PARK",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031320",
            "telephone_number": "270-926-4100",
            "fax_number": "270-684-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "REBECCA",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1074301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.