Active NPI
Jennifer Nicole Martin, MSN, ARNP
- Obstetrics & Gynecology Nurse Practitioner
- Ellensburg, WA
National Provider Identifier
1386643401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Nurse Practitioner
- License
- AP61005937
- Practice address
- 700 E Mountain View Ave Ste 505
Ellensburg, WA 98926-4802 - Phone
- (509) 426-3750
- Fax
- (509) 426-3760
- NPI assigned
- Jul 20, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Nurse Practitioner | 363LX0001X | AP61005937 | WA | Primary |
Addresses
Primary practice location
700 E Mountain View Ave Ste 505
Ellensburg, WA 98926-4802
Mailing address
700 E Mountain View Ave
Ellensburg, WA 98926-4802
Phone (509) 426-3750
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 305957000 | Medicaid | FL |
Other names 1
- Jennifer Nicole Myers
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AP61005937 | WA | MD | Obstetrics & Gynecology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Basalt Family Wellness, LLC | Past | Accepting new patients | |
| B Well | Past | Accepting new patients |
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.
-
- Clinic/Center
- Ellensburg, WA
- NPI 1154198653
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715558400000",
"number": "1386643401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 E MOUNTAIN VIEW AVE",
"city": "ELLENSBURG",
"state": "WA",
"postal_code": "989264802",
"telephone_number": "509-426-3750",
"fax_number": "509-426-3760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 E MOUNTAIN VIEW AVE STE 505",
"city": "ELLENSBURG",
"state": "WA",
"postal_code": "989264802",
"telephone_number": "509-426-3750",
"fax_number": "509-426-3760"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JENNIFER",
"middle_name": "NICOLE",
"name_prefix": "Mrs.",
"credential": "MSN, ARNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-20",
"last_updated": "2024-05-13",
"certification_date": "2024-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LX0001X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Obstetrics & Gynecology",
"state": "WA",
"license": "AP61005937",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "305957000",
"state": "FL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "MYERS",
"middle_name": "NICOLE",
"credential": "MSN, ARNP",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Ellensburg, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.