Active NPI
Martin Podiatry LLC
- Podiatric Clinic/Center
- Enid, OK
National Provider Identifier
1497274609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatric Clinic/Center
- License
- 117
- Legal business name
- MARTIN PODIATRY LLC
- Practice address
- 2501 N Van Buren St
Enid, OK 73703-1711 - Phone
- (580) 402-2146
- Fax
- (405) 285-8921
- NPI assigned
- Sep 19, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Michael H Martin, DPM
- Title
- Owner
- Phone
- (580) 402-2146
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatric Clinic/Center | 261QP1100X | 117 | OK | Primary |
Addresses
Primary practice location
2501 N Van Buren St
Enid, OK 73703-1711
Mailing address
PO Box 8584
Edmond, OK 73083-8584
Phone (580) 402-2146
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100780400A | Medicaid | OK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
2501 N Van Buren St
Enid, OK 73703
Phone (405) 471-6190
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Podiatrist
- Enid, OK
- NPI 1407831951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505779200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1505779200000",
"number": "1497274609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 8584",
"city": "EDMOND",
"state": "OK",
"postal_code": "730838584",
"telephone_number": "580-402-2146",
"fax_number": "405-285-8921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 N VAN BUREN ST",
"city": "ENID",
"state": "OK",
"postal_code": "737031711",
"telephone_number": "580-402-2146",
"fax_number": "405-285-8921"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MARTIN PODIATRY LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-09-19",
"last_updated": "2017-09-19",
"status": "A",
"authorized_official_last_name": "MARTIN",
"authorized_official_first_name": "MICHAEL",
"authorized_official_middle_name": "H",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "580-402-2146",
"authorized_official_credential": "DPM"
},
"taxonomies": [
{
"code": "261QP1100X",
"taxonomy_group": "",
"desc": "Clinic/Center, Podiatric",
"state": "OK",
"license": "117",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100780400A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Enid, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.