Individual provider Active NPI

Sandra Marya Martin, FNP-C

  • Family Nurse Practitioner
  • Hammond, LA
National Provider Identifier
1417609249
Registry record updated Jan 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
223693 Issued in LA
Practice address
44546 S Airport Rd Ste F
Hammond, LA 70403-0341
Phone
(985) 500-3500
NPI assigned
Jan 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2022

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 223693 LA Primary

Addresses

Primary practice location

44546 S Airport Rd Ste F
Hammond, LA 70403-0341

Mailing address

44546 S Airport Rd Ste F
Hammond, LA 70403-0341
Phone (985) 500-3500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20220214000622 LA Practitioner - Nurse Practitioner 5395138465 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223693LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Childrens Clinic LLC CurrentSince Nov 3, 2021 Accepting new patients
Integrated Medical Services Ham, LLC CurrentSince Mar 17, 2024 Accepting new patients

Locations

44546 S Airport Rd
Ste F
Hammond, LA 70403
Phone (985) 500-3500

303 W Minnesota Park Rd
Ste C
Hammond, LA 70403
Phone (985) 350-6110

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": "1642896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642896000000",
    "number": "1417609249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44546 S AIRPORT RD STE F",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704030341",
            "telephone_number": "985-500-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44546 S AIRPORT RD STE F",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704030341",
            "telephone_number": "985-500-3500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SANDRA",
        "middle_name": "MARYA",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-23",
        "last_updated": "2022-01-23",
        "certification_date": "2022-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "223693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.