Individual provider Active NPI

Christopher P. Martin, RN

  • Nurse Practitioner
  • Medicine Lodge, KS
National Provider Identifier
1407288640
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
TMP 147333 Issued in KS
Practice address
710 N Walnut St
Medicine Lodge, KS 67104-1019
Phone
(620) 886-3771
Fax
(620) 930-3784
NPI assigned
Jul 30, 2013
Last updated
Nov 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X TMP 147333 KS Primary
Registered Nurse 163W00000X 13-108020 KS

Addresses

Primary practice location

710 N Walnut St
Medicine Lodge, KS 67104-1019

Mailing address

710 N Walnut St
Medicine Lodge, KS 67104-1019
Phone (620) 886-3771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, AR, OK3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20141205001816 KS Practitioner - Nurse Practitioner 8527380336 Reassigns benefits to 3 organizations
I20220720002651 AR Practitioner - Nurse Practitioner 8527380336 Reassigns benefits to 1 organization
I20240319001271 OK Practitioner - Nurse Practitioner 8527380336 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Francis House Nwa, Inc.Group PAC ID 0042262495, 67 clinicians

Practice addresses (Care Compare)

1261 E Tulsa Ave
Kansas, OK 74347-7026
Phone (918) 868-2175

451 S Holly St
Siloam Springs, AR 72761-3018
Phone (479) 524-3141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13-108020KSMDRegistered Nurse
TMP 147333KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rooks County Health Center CurrentSince Jan 25, 2024 Accepting new patients
Medicine Lodge Memorial Hospital CurrentSince Sep 24, 2014 Accepting new patients
St Francis House Nwa, Inc CurrentSince Apr 29, 2024 Accepting new patients
St Francis House Nwa, Inc Current Accepting new patients
Medicine Lodge Memorial Hospital CurrentSince Sep 24, 2014 Accepting new patients
Rooks County Health Center CurrentSince Jan 25, 2024 Accepting new patients
St Francis House Nwa, Inc CurrentSince May 2, 2024 Accepting new patients
St. Francis House Nwa, Inc. Past Accepting new patients
Ahs Oklahoma Physician Group, LLC Past Accepting new patients

Locations

451 S Holly St
Siloam Springs, AR 72761
Phone (479) 524-3141

614 E Emma Ave
Ste 300
Springdale, AR 72764
Phone (479) 751-4898

710 N Walnut St
Medicine Lodge, KS 67104
Phone (620) 886-3771

1121 Neo Loop
Grove, OK 74344
Phone (877) 783-4441

1261 E Tulsa Ave
Kansas, OK 74347
Phone (918) 786-3391

Organizations & group practices 10

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416528000000",
    "number": "1407288640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N WALNUT ST",
            "city": "MEDICINE LODGE",
            "state": "KS",
            "postal_code": "671041019",
            "telephone_number": "620-886-3771",
            "fax_number": "620-930-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N WALNUT ST",
            "city": "MEDICINE LODGE",
            "state": "KS",
            "postal_code": "671041019",
            "telephone_number": "620-886-3771",
            "fax_number": "620-930-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CHRISTOPHER",
        "middle_name": "P.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2014-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "TMP 147333",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KS",
            "license": "13-108020",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medicine Lodge, KS

Sources for this page

Verify at the official NPI Registry.