Active NPI
Ross Martin, BSN, RN
- Student in an Organized Health Care Education/Training Program
- Thibodaux, LA
National Provider Identifier
1508673971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 1627 Highway 1
Thibodaux, LA 70301-5769 - Phone
- (985) 856-4462
- NPI assigned
- Dec 18, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 216163 | LA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
1627 Highway 1
Thibodaux, LA 70301-5769
Mailing address
1627 Highway 1
Thibodaux, LA 70301-5769
Phone (985) 856-4462
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
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 216163 | LA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1734480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734480000000",
"number": "1508673971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1627 HIGHWAY 1",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703015769",
"telephone_number": "985-856-4462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1627 HIGHWAY 1",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "703015769",
"telephone_number": "985-856-4462"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ROSS",
"credential": "BSN, RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-12-18",
"last_updated": "2024-12-18",
"certification_date": "2024-12-18",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "LA",
"license": "216163",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thibodaux, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.