Active NPI
Sandra Marya Martin, FNP-C
- Family Nurse Practitioner
- Hammond, LA
National Provider Identifier
1417609249
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 223693
- 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
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 |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 223693 | LA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornerstone Childrens Clinic LLC | Current | Accepting new patients | |
| Integrated Medical Services Ham, LLC | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.