NPIMap

Individual provider Active NPI

Molly Martin, MD

  • Family Medicine Physician
  • Kansas, OK
National Provider Identifier
1306469556
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
38340 Issued in OK
Practice address
1261 E Tulsa Ave
Kansas, OK 74347-7026
Phone
(918) 868-2175
NPI assigned
May 22, 2020
Last updated
Aug 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 38340 OK Primary

Addresses

Primary practice location

1261 E Tulsa Ave
Kansas, OK 74347-7026

Mailing address

1261 E Tulsa Ave
Kansas, OK 74347-7026
Phone (918) 868-2175

Other names 1

  • Molly Marietta Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, AR2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240820002871 OK Practitioner - Family Practice 1951849009 Reassigns benefits to 1 organization
I20250312003212 AR Practitioner - Family Practice 1951849009 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Francis House Nwa, Inc.Group PAC ID 0042262495, shared by 27 NPIs, 67 clinicians

Practice addresses (Care Compare)

1261 E Tulsa Ave
Kansas, OK 74347-7026
Phone (918) 868-2175

451 S Holly St
Siloam Springs, AR 72761-3018
Phone (479) 524-3141

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
38340OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis House Nwa, Inc CurrentSince Feb 20, 2025 Accepting new patients
St Francis House Nwa, Inc Current Accepting new patients
St Francis House Nwa, Inc CurrentSince Aug 5, 2024 Accepting new patients
St Francis House Nwa, Inc CurrentSince Aug 5, 2024 Accepting new patients
St. Francis House Nwa, Inc. Past Accepting new patients

Locations

451 S Holly St
Siloam Springs, AR 72761
Phone (479) 524-3141

614 E Emma Ave
Ste 300
Springdale, AR 72764
Phone (479) 751-4898

1121 Neo Loop
Grove, OK 74344
Phone (877) 783-4441

1261 E Tulsa Ave
Kansas, OK 74347
Phone (918) 786-3391

Organizations & group practices 5

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.

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1306469556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1261 E TULSA AVE",
            "city": "KANSAS",
            "state": "OK",
            "postal_code": "743477026",
            "telephone_number": "918-868-2175",
            "fax_number": "479-373-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1261 E TULSA AVE",
            "city": "KANSAS",
            "state": "OK",
            "postal_code": "743477026",
            "telephone_number": "918-868-2175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MOLLY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-22",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "38340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "MARIETTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kansas, OK

Sources for this page

Verify at the official NPI Registry.