Active NPI
Andrea Mae Martin
- School Registered Nurse
- Beckley, WV
National Provider Identifier
1629626841
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- 51243
- Practice address
- 105 Adair St
Beckley, WV 25801-3791 - Phone
- (304) 256-4500
- NPI assigned
- Aug 30, 2019
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | 51243 | WV | Primary |
Addresses
Primary practice location
105 Adair St
Beckley, WV 25801-3791
Mailing address
105 Adair St
Beckley, WV 25801-3791
Phone (304) 256-4500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 163W50200X | Medicaid | WV |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | amartin@k12.wv.us | ||
| Direct Messaging Address | amartin@k12.wv.us |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51243 | WV | MD | School Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567123200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567123200000",
"number": "1629626841",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 ADAIR ST",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258013791",
"telephone_number": "304-256-4500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 ADAIR ST",
"city": "BECKLEY",
"state": "WV",
"postal_code": "258013791",
"telephone_number": "304-256-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ANDREA",
"middle_name": "MAE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-08-30",
"last_updated": "2019-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "WV",
"license": "51243",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "163W50200X",
"state": "WV"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "amartin@k12.wv.us",
"affiliation": "N",
"address_1": "105 Adair St",
"city": "Beckley",
"state": "WV",
"country_code": "US",
"postal_code": "258013791",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "amartin@k12.wv.us",
"affiliation": "N",
"address_1": "105 Adair St",
"city": "Beckley",
"state": "WV",
"country_code": "US",
"postal_code": "258013791",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Beckley, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.