Active NPI
Martin Light
- Contractor
- Chesterfield, MO
National Provider Identifier
1568623544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 330 Branchport Dr
Chesterfield, MO 63017-2902 - Phone
- (314) 469-3484
- Fax
- (314) 469-3484
- NPI assigned
- Jun 22, 2008
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | NU | Primary |
Addresses
Primary practice location
330 Branchport Dr
Chesterfield, MO 63017-2902
Mailing address
330 Branchport Dr
Chesterfield, MO 63017-2902
Phone (314) 469-3484
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214092800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1568623544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 BRANCHPORT DR",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630172902",
"telephone_number": "314-469-3484",
"fax_number": "314-469-3484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 BRANCHPORT DR",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "630172902",
"telephone_number": "314-469-3484",
"fax_number": "314-469-3484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIGHT",
"first_name": "MARTIN",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-06-22",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesterfield, MO
- Stephanie Lickerman, APRN, ANP-BC
- Micah J Lieberman, D.C.
- Brandi Liebig, MS,CCC-SLP
- Life Care Home Health Services LLC
- Lifetime Dental Care of Missouri, Richard Straus, D.M.D., P.C. (Premier Dental Partners Chesterfield)
- Mariko Lighthart, OTR
- Roberta Lima, M.D.
- Linda Liu DMD, PC
- Suzanne Louise Share Lindhorst, MA, CCC-LSP
- Ellen H Lindsey, OT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.