Kristin King Martin, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP05592 Issued in LA

Practice address

1024 E Ascension Complex Blvd
Gonzales, LA 70737-4263

Phone

(225) 765-5500

Fax

(225) 644-2822

NPI assigned

Nov 17, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Our Lady of the Lake Physician Group LLC

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1033494943

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Our Lady of the Lake Physician Group LLC

  dba Our Lady of the Lake Children's Health Developmental Center at McMains

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Baton Rouge, LA
  • NPI 1235912502
  NPD
• Our Lady of the Lake Physician Group LLC

  dba OLOL Physician Surgical Specialty

  • Hematology & Oncology Physician
  • Baton Rouge, LA
  • NPI 1184671455

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1226880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1568616654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-765-5500",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1024 E ASCENSION COMPLEX BLVD",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374263",
            "telephone_number": "225-765-5500",
            "fax_number": "225-644-2822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17505 Jefferson Hwy",
            "address_purpose": "LOCATION",
            "city": "Prairieville",
            "state": "LA",
            "postal_code": "707693930",
            "country_code": "US",
            "telephone_number": "225-677-9547",
            "fax_number": "225-677-8983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KRISTIN",
        "middle_name": "KING",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-17",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN068268",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "677299",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP05592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khanh Mai
• Kendra Durr Main, LCSW-BACS
• Parissa L Majlesein, PT, DPT
• Stephen Bernard Manale, M.D.
• Michael Joseph Marchand Jr., RDN, LDN
• Renee Diez Martin, PT
• Scott Kenneth Martin, PA
• Betye J Mashack, ED.D.
• Karippelil E. Mathew, M.D.
• Leyamma Mathew, M.D.

• Family Nurse Practitioner in Gonzales, LA
• Providers in Gonzales, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.