Active NPI
Nicole G Martin, PHARM.D.
- Pharmacist
- Ripley, TN
National Provider Identifier
1497064315
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 9142
- Practice address
- 288 S Washington St
Ripley, TN 38063-1737 - Phone
- (731) 635-1461
- Fax
- (731) 635-5798
- NPI assigned
- Sep 27, 2010
- Last updated
- Sep 27, 2010
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9142 | TN | Primary |
Addresses
Primary practice location
288 S Washington St
Ripley, TN 38063-1737
Mailing address
893 Lacebark CV
Newbern, TN 38059-1488
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9142 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freds Stores of Tennessee Inc | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Freds Pharmacy 3648
- Community/Retail Pharmacy
- Greenville, MS
- NPI 1093969016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1285545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285545600000",
"number": "1497064315",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "893 LACEBARK CV",
"city": "NEWBERN",
"state": "TN",
"postal_code": "380591488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "288 S WASHINGTON ST",
"city": "RIPLEY",
"state": "TN",
"postal_code": "380631737",
"telephone_number": "731-635-1461",
"fax_number": "731-635-5798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "NICOLE",
"middle_name": "G",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-27",
"last_updated": "2010-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TN",
"license": "9142",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ripley, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.