Active NPI
Iva Fu Martin, FNP-BC
- Family Nurse Practitioner
- Spencer, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 28130723A
- Practice address
- 2542 E State Highway 46
Spencer, IN 47460-6807 - Phone
- (812) 219-6354
- NPI assigned
- May 30, 2009
- Last updated
- Jun 2, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 28130723A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | 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.
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Emergency Medicine
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.