Valerie B Martin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0154 Issued in ND

Practice address

240 Main Street
Ellendale, ND 58436

Phone

(701) 349-3666

Fax

(701) 349-4945

NPI assigned

Nov 13, 2006

Last updated

Feb 21, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Valerie B Vandervorst Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1477624278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1460",
            "city": "ABERDEEN",
            "state": "SD",
            "postal_code": "574021460",
            "telephone_number": "605-622-2876",
            "fax_number": "605-622-2804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 MAIN STREET",
            "city": "ELLENDALE",
            "state": "ND",
            "postal_code": "58436",
            "telephone_number": "701-349-3666",
            "fax_number": "701-349-4945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "VALERIE",
        "middle_name": "B",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "ND",
            "license": "0154",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "0342",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5301013",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VALERIE",
            "last_name": "VANDERVORST",
            "middle_name": "B",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brittanie Rose Hamar, PHARMD
• Craig L Kendall, DC
• Nicholas Knight
• Jordan Kulczyk
• Bonnie Kay Lehnhoff
• Jennifer Marie Maus, OTR
• Harleigh Miller
• Cindy Nash
• Cindy Olstad
• Barbara Ritter, LICSW

• Physician Assistant in Ellendale, ND
• Providers in Ellendale, ND by specialty
• Physician Assistant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; 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.