Mirenda Martin, APRN

Primary specialty

Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X

License

A004739 Issued in AR

Practice address

507 N Main Street
Salem Family Clinic 507 N Main Street
Salem, AR 72576

Phone

(870) 895-2541

NPI assigned

Jul 19, 2016

Last updated

Jul 19, 2016By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 AR

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

Practice roles

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.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1407209075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "address_2": "PO BOX 189",
            "city": "SALEM",
            "state": "AR",
            "postal_code": "725760189",
            "telephone_number": "870-895-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 N MAIN STREET",
            "address_2": "SALEM FAMILY CLINIC 507 N MAIN STREET",
            "city": "SALEM",
            "state": "AR",
            "postal_code": "72576",
            "telephone_number": "870-895-2541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "MIRENDA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "AR",
            "license": "A004739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Drugs Inc
• Tim Leslie, R.PH.
• LHCG CV, LLC (Elite Community-Based Services)
• Lifelong Health Center, Inc.
• Holly Candace Martin, OTR/L
• Sandra Massey
• Elisabeth Mathews, PHARM. D.
• Venita Lynne Ninemire
• North Arkanas Electric Cooperative Inc
• Northeast Arkansas Community Mental Health Center Inc (Mid South Health Systems)

• Family Health Clinical Nurse Specialist in Salem, AR
• Providers in Salem, AR by specialty
• Family Health Clinical Nurse Specialist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; 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.