Martin Maurus Kidwell, DAOM, L.AC.

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

AC01116 Issued in OR

Practice address

685 Portland Ave
Gladstone, OR 97027-2117

Phone

(503) 891-2352

Fax

(503) 655-2146

NPI assigned

Mar 13, 2007

Last updated

Apr 5, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Best Practice, LLC

  dba Best Practice Acupuncture

  • Clinic/Center
  • Tigard, OR
  • NPI 1194451666
  NPD Authorized official

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1508999061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5240 SE KING GEORGE CT",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972676132",
            "telephone_number": "503-891-2352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 PORTLAND AVE",
            "city": "GLADSTONE",
            "state": "OR",
            "postal_code": "970272117",
            "telephone_number": "503-891-2352",
            "fax_number": "503-655-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIDWELL",
        "first_name": "MARTIN",
        "middle_name": "MAURUS",
        "credential": "DAOM, L.AC.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "OR",
            "license": "AC01116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Keith, LPC
• Rachel Kelly, ND
• Rachel Kenner
• Kenneth Meigs DO LLC
• Keystone Chiropractic LLC
• Gerald Marlin King, DO
• Britanny Kochenderfer, LPC
• Michael Koranteng
• Courtney Michael Kraus, PHARMD
• Candace Lee Krause, D.M.D.

• Acupuncturist in Gladstone, OR
• Providers in Gladstone, OR by specialty
• Acupuncturist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 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.

Verify at the official NPI Registry.