NPIMap

Organization Active NPI

Ken Martin DO LLC

  • Family Medicine Physician
  • Tampa, FL
National Provider Identifier
1467833525
Registry record updated Jun 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS4318 Issued in FL
Legal business name
KEN MARTIN DO LLC
Practice address
9270 Bay Plaza Blvd
Ste 640
Tampa, FL 33619-4499
Phone
(813) 376-0734
NPI assigned
Jun 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2015

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

Authorized official

Name
Kenneth Martin, DONPI 1790770600
Title
Owner
Phone
(813) 376-0734

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X OS4318 FL Primary

Addresses

Primary practice location

9270 Bay Plaza Blvd
Ste 640
Tampa, FL 33619-4499

Mailing address

9270 Bay Plaza Blvd
Ste 640
Tampa, FL 33619-4499
Phone (813) 376-0734

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1434326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1434326400000",
    "number": "1467833525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9270 BAY PLAZA BLVD",
            "address_2": "STE 640",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194499",
            "telephone_number": "813-376-0734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9270 BAY PLAZA BLVD",
            "address_2": "STE 640",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194499",
            "telephone_number": "813-376-0734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEN MARTIN DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-15",
        "last_updated": "2015-06-15",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "813-376-0734",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS4318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2015; 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.