Individual provider Active NPI

Deborah G. Martin, A.R.N.P.

  • Obstetrics & Gynecology Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1427035294
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
License
ARNP 1645032 Issued in FL
Practice address
2454 N McMullen Booth Rd
Ste 601
Clearwater, FL 33759-1353
Phone
(727) 796-7705
Fax
(727) 796-8764
NPI assigned
Dec 22, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X ARNP 1645032 FL Primary
Occupational Health Nurse Practitioner 363LX0106X ARNP 1645032 FL
Adult Health Nurse Practitioner 363LA2200X ARNP 1645032 FL

Addresses

Primary practice location

2454 N McMullen Booth Rd
Ste 601
Clearwater, FL 33759-1353

Mailing address

2454 N McMullen Booth Rd
Ste 601
Clearwater, FL 33759-1353
Phone (727) 796-7705

Other identifiers 1

IdentifierTypeStateIssuer
ARNP 1645032OtherFLMEDICAL LICENSE

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)
Not enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP 1645032FLMDObstetrics & Gynecology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1427035294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2454 N MCMULLEN BOOTH RD",
            "address_2": "STE 601",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337591353",
            "telephone_number": "727-796-7705",
            "fax_number": "727-796-8764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2454 N MCMULLEN BOOTH RD",
            "address_2": "STE 601",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337591353",
            "telephone_number": "727-796-7705",
            "fax_number": "727-796-8764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "DEBORAH",
        "middle_name": "G.",
        "name_prefix": "Mrs.",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "ARNP 1645032",
            "primary": true
        },
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "FL",
            "license": "ARNP 1645032",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP 1645032",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ARNP 1645032",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; 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.