Phillip K Martin, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

2379 Issued in KS

Practice address

7829 E Rockhill St
Attn: Credentialing
Wichita, KS 67206-3920

Phone

(316) 293-3850

Fax

(855) 881-8087

NPI assigned

Jul 26, 2016

Sex

Male

Sole proprietor

No

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

Enrolled in KS

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University of Kansas School of Medicine Wichita Medical Practice AssocGroup PAC ID 3577464841, 54 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• University of Kansas School of Medicine Wichita Medical Practice Assoc

  • Internal Medicine Physician
  • Wichita, KS
  • NPI 1639143712
  Medicare reassignment Care Compare group NPD
• Kansas University School of Medicine - Wichita

  • Adult Mental Health Clinic/Center
  • Wichita, KS
  • NPI 1467900894
  NPD (past)

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469491200000",
    "number": "1619420718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 N KANSAS ST STE 3054",
            "address_2": "ATTN: CREDENTIALING",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672143124",
            "telephone_number": "316-293-2611",
            "fax_number": "316-293-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7829 E ROCKHILL ST",
            "address_2": "ATTN: CREDENTIALING",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672063920",
            "telephone_number": "316-293-3850",
            "fax_number": "855-881-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PHILLIP",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "KS",
            "license": "2379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey Taylor Martin, OTR/L
• McKenna Martin, LPC-T
• Melissa A Martin
• Minnie Martin, LSCSW
• Noelle Martin, LSCSW
• Ronda Ten Eych Martin, CRNA
• Sanjuanita Jailene Martin
• Shawn Sitka Martin, M.S., LCMFT
• Spencer Martin
• Susan D Martin, RD/LD/CDE

• Clinical Neuropsychologist in Wichita, KS
• Providers in Wichita, KS by specialty
• Clinical Neuropsychologist in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.