Jean Ellen Martin, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

71003218A Issued in IN

Practice address

2824 Elkhart Rd
Goshen, IN 46526-1014

Phone

(574) 535-1700

Fax

(574) 535-1799

NPI assigned

Jan 11, 2010

Last updated

May 3, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: jean.martin@goshenhealthdirect.com

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.

• Goshen Health System Inc

  • Family Medicine Physician
  • Goshen, IN
  • NPI 1194772293
  Medicare reassignment
• Goshen Hospital Association Inc

  dba Goshen Cancer Center Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Goshen, IN
  • NPI 1548590847
  NPD (past)

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

{
    "created_epoch": "1263168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1518297779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 834",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465270834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2824 ELKHART RD",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465261014",
            "telephone_number": "574-535-1700",
            "fax_number": "574-535-1799"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1808 Charlton Ct",
            "address_purpose": "LOCATION",
            "city": "Goshen",
            "state": "IN",
            "postal_code": "465266463",
            "country_code": "US",
            "telephone_number": "574-533-2599",
            "fax_number": "574-533-2681",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JEAN",
        "middle_name": "ELLEN",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-11",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71003218A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71003218A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200981470",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jean.martin@goshenhealthdirect.com",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "2824 Elkhart Rd",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465261014",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Morgan Markel
• Michelle Earle Marquis, LMT
• Athziry Marrufo
• Barry Marshall, M. S.
• Emily Martin, FNP
• Kimberly J Martin, MSW
• Lori Ann Martin, CNM
• Patricia Lynn Martin, LMFT
• Randall Lee Martin, D.C.
• Rosa Alba Martinez Lopez

• Nurse Practitioner in Goshen, IN
• Providers in Goshen, IN by specialty
• Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.