Connie I. Martin, CST

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

122672 Issued in AZ

Practice address

1101 E Missouri Ave
Phoenix, AZ 85014-2709

Phone

(602) 222-2221

Fax

(602) 266-2044

NPI assigned

Feb 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Connie Weaver Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Eyenet Triage, PLC

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1932553211
  NPD (past)
• Retinal Consultants of Arizona LTD

  • Ophthalmology Physician
  • Phoenix, AZ
  • NPI 1700823051
  NPD (past)

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

{
    "created_epoch": "1454976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454976000000",
    "number": "1619335379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32530",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850642530",
            "telephone_number": "602-222-2221",
            "fax_number": "602-266-2044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 E MISSOURI AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850142709",
            "telephone_number": "602-222-2221",
            "fax_number": "602-266-2044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CONNIE",
        "middle_name": "I.",
        "credential": "CST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-09",
        "last_updated": "2016-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "AZ",
            "license": "122672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CST CERTIFICATE NUMBER",
            "identifier": "122672",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "WEAVER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Benjamin Martin, PA-C
• Bosco C Martin, MD
• Brook A Martin, LMSW
• Christopher Loren Martin, MD
• Christy Martin, LPC
• Dale Jerome Martin Jr.
• Dean T Martin, MD
• Douglas Martin
• Elisabeth Ann Martin
• Erik Jeff Martin, MD

• Surgical Technologist in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Surgical Technologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2016; 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.