NPIMap

Organization Active NPI

Nicholette Martin LLC

  • Specialist
  • Bowie, MD
National Provider Identifier
1407884075
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0050415 Issued in MD
Legal business name
NICHOLETTE MARTIN LLC
Practice address
4000 Mitchellville Rd
Suite B322
Bowie, MD 20716-3104
Phone
(301) 860-0305
Fax
(301) 806-0307
NPI assigned
Jun 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Authorized official

Name
Dr. Nicholette M Martin, MD
Title
Managing Partner
Phone
(301) 860-0305

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X D0050415 MD Primary

Addresses

Primary practice location

4000 Mitchellville Rd
Suite B322
Bowie, MD 20716-3104

Mailing address

PO Box 4322
Crofton, MD 21114-4322
Phone (301) 860-0305

Other names 1

  • Nicholette Martin-Davis, LLC Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395100800000",
    "number": "1407884075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4322",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211144322",
            "telephone_number": "301-860-0305",
            "fax_number": "301-860-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MITCHELLVILLE RD",
            "address_2": "SUITE B322",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163104",
            "telephone_number": "301-860-0305",
            "fax_number": "301-806-0307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLETTE MARTIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2014-03-18",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "NICHOLETTE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "301-860-0305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0050415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Nicholette Martin-Davis, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.