Individual provider Active NPI

Kendra Denise Martin, NP

  • Primary Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1316784408
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
5020413 Issued in NC
Practice address
4055 Valley View LN Ste 700
Dallas, TX 75244-5045
Phone
(817) 683-4135
NPI assigned
Jul 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 5020413 NC Primary

Addresses

Primary practice location

4055 Valley View LN Ste 700
Dallas, TX 75244-5045

Mailing address

1101 Bitting Hall Cir
Rural Hall, NC 27045-9911
Phone (336) 416-1299

Other practice location 1

1695 Kernersville Medical Pkwy
Kernersville, NC 27284-7159
Phone (336) 515-5000

Other names 1

  • Kendra Denise Nowling Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241204000671 NC Practitioner - Nurse Practitioner 9032645866 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health Medical Associates, PLLC CurrentSince Sep 1, 2024 Accepting new patients
Salisbury Vamc PastSince Jan 21, 2022 Accepting new patients

Locations

555 Fayetteville St
Raleigh, NC 27601
Phone (682) 268-1011

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1721001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1316784408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 BITTING HALL CIR",
            "city": "RURAL HALL",
            "state": "NC",
            "postal_code": "270459911",
            "telephone_number": "336-416-1299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4055 VALLEY VIEW LN STE 700",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445045",
            "telephone_number": "817-683-4135"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1695 Kernersville Medical Pkwy",
            "address_purpose": "LOCATION",
            "city": "Kernersville",
            "state": "NC",
            "postal_code": "272847159",
            "country_code": "US",
            "telephone_number": "336-515-5000",
            "fax_number": "336-515-5310",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KENDRA",
        "middle_name": "DENISE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-15",
        "last_updated": "2024-07-15",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5020413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "NOWLING",
            "middle_name": "DENISE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.