Carolyn Marie Martin, MSN, FNP-C, BC

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

532239 Issued in TX

Practice address

17101 Preston Rd Ste 200
Dallas, TX 75248-1374

Phone

(972) 239-4441

Fax

(972) 239-1597

NPI assigned

Apr 2, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carolyn.martin@klwmp.eclinicaldirectplus.com

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.

• Kelly L Wimberly MD PA

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1578589842
  Medicare reassignment NPD
• Terrence F Henry M.D., P.a.

  • Family Medicine Physician
  • Plano, TX
  • NPI 1760652176
  NPD (past)

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560729600000",
    "number": "1447423108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5812 FURNEAUX DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750934729",
            "telephone_number": "972-608-2634",
            "fax_number": "972-964-5348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17101 PRESTON RD STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481374",
            "telephone_number": "972-239-4441",
            "fax_number": "972-239-1597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 W 15th St",
            "address_2": "Suite 112",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750935803",
            "country_code": "US",
            "telephone_number": "972-596-6917",
            "fax_number": "972-964-5348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CAROLYN",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSN, FNP-C, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2019-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "532239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Star Martin, CRNA
• Brizeek T Martin, PHARMD
• Caitlin M Martin, SLP-INTERN
• Cal Martin, DDS, MS
• Caroline Elizabeth Martin, CPNP
• Casey R. Martin, CRNA
• Christine Margaret Martin, LCSW
• Christopher Michael Martin, PA-C
• Christopher Troy Martin, M.D.
• Cornelius Martin, LCSW

• Registered Nurse in Dallas, TX
• Providers in Dallas, TX by specialty
• Registered Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2019; 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.

Verify at the official NPI Registry.