Individual provider Active NPI

Michelle Martz, FNP

  • Family Nurse Practitioner
  • Cleveland, TN
National Provider Identifier
1366162067
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
35599 Issued in TN
Practice address
1940 Westland Dr SW
Cleveland, TN 37311-8102
Phone
(914) 364-6857
NPI assigned
Sep 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 35599 TN Primary
Registered Nurse 163W00000X 275908 TN
Family Nurse Practitioner 363LF0000X APRN11021657 FL

Addresses

Primary practice location

1940 Westland Dr SW
Cleveland, TN 37311-8102

Mailing address

12607 Myrtle Ridge LN
Knoxville, TN 37932-2738

Other practice location 1

1 Veterans Way
Knoxville, TN 37931-3161
Phone (865) 862-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20240812002734 TN Practitioner - Nurse Practitioner 4587102314 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
275908TNMDRegistered Nurse
35599TNMDObstetrics & Gynecology Physician
APRN11021657FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Theoria Medical CurrentSince Sep 26, 2024 Accepting new patients

Locations

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

1940 Westland Dr SW
Cleveland, TN 37311
Phone (423) 202-8132

1 Veterans Way
Knoxville, TN 37931
Phone (855) 240-2530

Organizations & group practices 1

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": "1661990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1366162067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12607 MYRTLE RIDGE LN",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379322738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 WESTLAND DR SW",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373118102",
            "telephone_number": "914-364-6857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Veterans Way",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379313161",
            "country_code": "US",
            "telephone_number": "865-862-8100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTZ",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-01",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "35599",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "275908",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11021657",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.