Antonia Deanitra Martin, APRN, WHNP-BC

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

1094681 Issued in TX

Practice address

1777 N Record St Apt 4301
Dallas, TX 75202-1266

Phone

(870) 833-0149

NPI assigned

Dec 27, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: antonia.martin.1@17390.direct.athenahealth.com

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.

• Martin Luther King Jr Family Clinic

  • Federally Qualified Health Center (FQHC)
  • Dallas, TX
  • NPI 1851492557
  Medicare reassignment NPD
• Dallas County Mental Health & Mental Retardation Center

  • Psychiatry Physician
  • Dallas, TX
  • NPI 1023239886
  NPD (past)

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

{
    "created_epoch": "1672099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672099200000",
    "number": "1376256164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 N RECORD ST APT 4301",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752021266",
            "telephone_number": "870-833-0149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 N RECORD ST APT 4301",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752021266",
            "telephone_number": "870-833-0149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ANTONIA",
        "middle_name": "DEANITRA",
        "credential": "APRN, WHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-27",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TX",
            "license": "1094681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Martin
• Amy Green Martin, M.D.
• Andrea Suzanne Martin, RN, MSN, FNP-C
• Andrew Martin, CRNA
• Angela Cristi Martin, LCSW
• Ashley Star Martin, CRNA
• Brizeek T Martin, PHARMD
• Caitlin M Martin, SLP-INTERN
• Cal Martin, DDS, MS
• Caroline Elizabeth Martin, CPNP

• Women's Health Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Women's Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.