Individual provider Active NPI

Kristy Kay Martin, APRN-CNS

  • Clinical Nurse Specialist
  • Tulsa, OK
National Provider Identifier
1457618613
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Nurse SpecialistTaxonomy code 364S00000X
License
R0057565 Issued in OK
Practice address
6465 S Yale Ave
Suite 507
Tulsa, OK 74136-7823
Phone
(918) 481-2760
Fax
(918) 481-2775
NPI assigned
Apr 12, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Nurse Specialist 364S00000X R0057565 OK Primary

Addresses

Primary practice location

6465 S Yale Ave
Suite 507
Tulsa, OK 74136-7823

Mailing address

6465 S Yale Ave
Suite 507
Tulsa, OK 74136-7823
Phone (918) 481-2760

Other identifiers 1

IdentifierTypeStateIssuer
200428170AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20120719000486 OK Practitioner - Certified Clinical Nurse Specialist (CNS) 9739345836 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tni-Kso PCGroup PAC ID 2062464399, 20 clinicians

Practice addresses (Care Compare)

6465 S Yale Ave
Suite 507
Tulsa, OK 74136-7807
Phone 9187125000152

Hospital & facility affiliations

  • Cherokee Nation W W Hastings Indian Hospital Hospital, Tahlequah, OK, CCN 370171
  • Hillcrest Hospital Pryor Hospital, Pryor, OK, CCN 370015
  • Hillcrest Medical Center Hospital, Tulsa, OK, CCN 370001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
R0057565OKMDClinical Nurse Specialist

Interoperability endpoints

  • Direct secure messaging: kristy.martin@direct.davitaphysiciansolutions.com

Organizations & group practices 1

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1457618613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE",
            "address_2": "SUITE 507",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367823",
            "telephone_number": "918-481-2760",
            "fax_number": "918-481-2775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6465 S YALE AVE",
            "address_2": "SUITE 507",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741367823",
            "telephone_number": "918-481-2760",
            "fax_number": "918-481-2775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KRISTY",
        "middle_name": "KAY",
        "credential": "APRN-CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364S00000X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist",
            "state": "OK",
            "license": "R0057565",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200428170A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.