Active NPI
Jeremy Travis Martin
- Registered Nurse
- Harrisville, WV
National Provider Identifier
1467176271
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 54103
- Practice address
- 888 E Main St
Harrisville, WV 26362-1300 - Phone
- (304) 305-1935
- NPI assigned
- Sep 27, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 54103 | WV | Primary |
Addresses
Primary practice location
888 E Main St
Harrisville, WV 26362-1300
Mailing address
888 E Main St
Harrisville, WV 26362-1300
Phone (304) 305-1935
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Desktop/Tablet | ||
| CONNECT URL | desktop/tablet |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 54103 | WV | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Housecalls Home Health and Hospice, LLC | Past | Accepting new patients |
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.
-
- Community Based Hospice Care Agency
- Parkersburg, WV
- NPI 1376603761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664236800000",
"number": "1467176271",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "888 E MAIN ST",
"city": "HARRISVILLE",
"state": "WV",
"postal_code": "263621300",
"telephone_number": "304-305-1935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "888 E MAIN ST",
"city": "HARRISVILLE",
"state": "WV",
"postal_code": "263621300",
"telephone_number": "304-305-1935"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "JEREMY",
"middle_name": "TRAVIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-09-27",
"last_updated": "2022-09-27",
"certification_date": "2022-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WV",
"license": "54103",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Desktop/Tablet",
"affiliation": "N",
"address_1": "888 E Main St",
"city": "Harrisville",
"state": "WV",
"country_code": "US",
"postal_code": "263621300",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "desktop/tablet",
"affiliation": "N",
"address_1": "888 E Main St",
"city": "Harrisville",
"state": "WV",
"country_code": "US",
"postal_code": "263621300",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Harrisville, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.