Individual provider Active NPI

Iva Fu Martin, FNP-BC

  • Family Nurse Practitioner
  • Spencer, IN
National Provider Identifier
1285860668
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
28130723A Issued in IN
Practice address
2542 E State Highway 46
Spencer, IN 47460-6807
Phone
(812) 219-6354
NPI assigned
May 30, 2009
Last updated
Jun 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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 28130723A IN Primary

Addresses

Primary practice location

2542 E State Highway 46
Spencer, IN 47460-6807

Mailing address

2542 E State Highway 46
Spencer, IN 47460-6807
Phone (812) 219-6354

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, UT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20091217000506 IN Practitioner - Nurse Practitioner 5698815900 Reassigns benefits to 1 organization
I20190912003040 UT Practitioner - Nurse Practitioner 5698815900 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

5373 S Green St
Suite 400
Murray, UT 84123-4740
Phone (866) 415-6556

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
28130723AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 5, 2019 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Ihc Health Services Inc CurrentSince Aug 5, 2019 Accepting new patients
Intermountain Medical Group Denver, LLC Emergency Medicine Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

5373 S Green St
Ste 400
Salt Lake City, UT 84123
Phone (801) 442-2615

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1243641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1285860668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2542 E STATE HIGHWAY 46",
            "city": "SPENCER",
            "state": "IN",
            "postal_code": "474606807",
            "telephone_number": "812-219-6354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2542 E STATE HIGHWAY 46",
            "city": "SPENCER",
            "state": "IN",
            "postal_code": "474606807",
            "telephone_number": "812-219-6354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "IVA",
        "middle_name": "FU",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-30",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28130723A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spencer, IN

Sources for this page

Verify at the official NPI Registry.