Jacqulyn Loraine Martin, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2008652 Issued in TX

Practice address

1400 Hilltop Rd
Kerrville, TX 78028-2851

Phone

(830) 895-3200

Fax

(830) 895-3865

NPI assigned

Aug 30, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Jacqulyn Loraine Martin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535587200000",
    "number": "1487136172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 TWO PINES LN",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786245861",
            "telephone_number": "830-998-9972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HILLTOP RD",
            "city": "KERRVILLE",
            "state": "TX",
            "postal_code": "780282851",
            "telephone_number": "830-895-3200",
            "fax_number": "830-895-3865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JACQULYN",
        "middle_name": "LORAINE",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-30",
        "last_updated": "2018-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2008652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "2008652",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACQULYN",
            "last_name": "MARTIN",
            "middle_name": "LORAINE",
            "prefix": "MS.",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Marks
• Cynthia Dianne Marrs, LPC
• Wayne Dean Marrs Jr., LCSW
• Marsha Nunley MD PA
• Quentella M Martin-Ellis, RN
• Lisa Martin, L.P.C., L.M.F.T
• Michael Winfield Martin, MD
• Ricky Anton Martin
• Amanda Renee Martinez
• Tracy Martinez, FNP

• Physical Therapy Assistant in Kerrville, TX
• Providers in Kerrville, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; 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.