Individual provider Active NPI

Katherine Mary Martin, CNM

  • Advanced Practice Midwife
  • Minneapolis, MN
National Provider Identifier
1356782007
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
R177458-4 Issued in MN
Practice address
606 24TH Ave S
Minneapolis, MN 55454-1455
Phone
(612) 273-7111
Fax
(612) 273-7112
NPI assigned
Jul 10, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X R177458-4 MN Primary

Addresses

Primary practice location

606 24TH Ave S
Minneapolis, MN 55454-1455

Mailing address

420 Delaware St SE
MMC 395
Minneapolis, MN 55455-0341

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130827000294 MN Practitioner - Certified Nurse Midwife (CNM) 9335382142 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
R177458-4MNMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Group Health, Inc. Current Accepting new patients
Fairview Express Care Current Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Fairview Express Care CurrentSince Jan 1, 2019 Accepting new patients
Group Health, Inc. CurrentSince Aug 18, 2018 Accepting new patients

Locations

717 Delaware St SE
Ste 340
Minneapolis, MN 55414
Phone (612) 625-3617

720 Washington Ave SE
Minneapolis, MN 55414
Phone (612) 883-0649

606 24th Ave S
Minneapolis, MN 55454
Phone (612) 273-3332

420 Delaware St SE
#395
Minneapolis, MN 55455
Phone (612) 301-3417

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

909 Fulton St SE
Minneapolis, MN 55455
Phone (612) 273-8383

720 Washington Ave SE
Ste 300
Minneapolis, MN 55414
Phone (612) 884-0769

205 Wabasha St S
Saint Paul, MN 55107
Phone (651) 293-8100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1356782007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 DELAWARE ST SE",
            "address_2": "MMC 395",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554550341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 24TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541455",
            "telephone_number": "612-273-7111",
            "fax_number": "612-273-7112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KATHERINE",
        "middle_name": "MARY",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-10",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "R177458-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.