Active NPI
Robert J Martin, M.D.
- Neurological Surgery Physician
- Ormond Beach, FL
National Provider Identifier
1407918352
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- ME 98396
- Practice address
- 873 Sterthaus Ave
#303
Ormond Beach, FL 32174-5189 - Phone
- (386) 671-6591
- Fax
- (386) 671-6598
- NPI assigned
- Dec 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | ME 98396 | FL | Primary |
Addresses
Primary practice location
873 Sterthaus Ave
#303
Ormond Beach, FL 32174-5189
Mailing address
305 Memorial Medical Parkway
Suite 206
Daytona Beach, FL 32117
Phone (386) 231-3540
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000765058A | Medicaid | GA |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 98396 | FL | MD | Neurological Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1283472000000",
"number": "1407918352",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "305 MEMORIAL MEDICAL PARKWAY",
"address_2": "SUITE 206",
"city": "DAYTONA BEACH",
"state": "FL",
"postal_code": "32117",
"telephone_number": "386-231-3540",
"fax_number": "386-231-3544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "873 STERTHAUS AVE",
"address_2": "#303",
"city": "ORMOND BEACH",
"state": "FL",
"postal_code": "321745189",
"telephone_number": "386-671-6591",
"fax_number": "386-671-6598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ROBERT",
"middle_name": "J",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-15",
"last_updated": "2010-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "FL",
"license": "ME 98396",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000765058A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ormond Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.