Individual provider Active NPI

Lynne K Martin, O.D.

  • Optometrist
  • Round Rock, TX
National Provider Identifier
1396834115
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4499T Issued in TX
Practice address
2701 S Interstate 35
Round Rock, TX 78664-7320
Phone
(512) 388-2600
Fax
(512) 388-2600
NPI assigned
Oct 11, 2006
Last updated
Mar 27, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4499T TX Primary
Corneal and Contact Management Optometrist 152WC0802X 4499T TX

Addresses

Primary practice location

2701 S Interstate 35
Round Rock, TX 78664-7320

Mailing address

1308 Arronimink Cir
Austin, TX 78746-6303
Phone (512) 785-0624

Other identifiers 8

IdentifierTypeStateIssuer
019327801MedicaidTX
920532OtherTXBLOCK (CHIP & AMERIGROUP)
26310OtherTXMEDICAL EYE SERVICES
64765OtherTXSAFEGUARD
47839OtherTXDAVIS
35403OtherTXAVESIS
47839OtherTXDAVIS VISION
26903OtherTXSPECTERA

Other names 1

  • Dr. Eva Lynne Kennington Former name

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

State licenses

LicenseStateTypeSpecialty
4499TTXMDCorneal and Contact Management Optometrist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1396834115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1308 ARRONIMINK CIR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787466303",
            "telephone_number": "512-785-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 S INTERSTATE 35",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786647320",
            "telephone_number": "512-388-2600",
            "fax_number": "512-388-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LYNNE",
        "middle_name": "K",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4499T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "4499T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019327801",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLOCK (CHIP & AMERIGROUP)",
            "identifier": "920532",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL EYE SERVICES",
            "identifier": "26310",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SAFEGUARD",
            "identifier": "64765",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS",
            "identifier": "47839",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVESIS",
            "identifier": "35403",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "47839",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "26903",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVA",
            "last_name": "KENNINGTON",
            "middle_name": "LYNNE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Round Rock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.