Individual provider Active NPI

Laura Martin, APRN

  • Family Nurse Practitioner
  • West Palm Beach, FL
National Provider Identifier
1407319122
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11001102 Issued in FL
Practice address
1645 Palm Beach Lakes Blvd Ste 240
West Palm Beach, FL 33401-2205
Phone
(954) 358-9955
NPI assigned
Apr 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11001102 FL Primary

Addresses

Primary practice location

1645 Palm Beach Lakes Blvd Ste 240
West Palm Beach, FL 33401-2205

Mailing address

1645 Palm Beach Lakes Blvd Ste 240
West Palm Beach, FL 33401-2205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20240101000142 FL Practitioner - Nurse Practitioner 2062862261 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11001102FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Gastro Health LLC Current Accepting new patients
Gastro Health, LLC CurrentSince Jan 29, 2024 Accepting new patients

Locations

4675 Linton Blvd
Ste 202
Delray Beach, FL 33445
Phone (561) 495-5700

12251 Taft St
Ste 401
Pembroke Pines, FL 33026
Phone (954) 433-5900

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.

NPI Registry JSON

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1407319122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1645 PALM BEACH LAKES BLVD STE 240",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1645 PALM BEACH LAKES BLVD STE 240",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334012205",
            "telephone_number": "954-358-9955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "LAURA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-09",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.