Individual provider Active NPI

Danette Lynn Martyn, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Newberry, MI
National Provider Identifier
1639736945
Registry record updated Jun 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704205351 Issued in MI
Practice address
7913 County Road 385
Newberry, MI 49868-7508
Phone
(906) 322-1806
NPI assigned
May 22, 2019
Last updated
Jun 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X 4704205351 MI Primary

Addresses

Primary practice location

7913 County Road 385
Newberry, MI 49868-7508

Mailing address

7913 County Road 385
Newberry, MI 49868-7508
Phone (906) 293-1981

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20230430000021 MI Practitioner - Nurse Practitioner 0446615207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Central MichiganGroup PAC ID 6103733092, 183 clinicians

Practice addresses (Care Compare)

1890 US Hwy 131
Unit 4
Petoskey, MI 49770-8344
Phone (231) 487-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704205351MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Central Michigan Single Specialty Current Accepting new patients
McLaren Central Michigan Single Specialty CurrentSince Jun 18, 2023 Accepting new patients
McLaren Central Michigan CurrentSince Jun 18, 2023 Accepting new patients
McLaren Central Michigan Past Accepting new patients

Locations

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

1890 US Highway 131
Unit 4
Petoskey, MI 49770
Phone (231) 348-2828

Interoperability endpoints

  • Direct secure messaging: danette.martyn@115443077021700.direct.elationemr.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1558483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622937600000",
    "number": "1639736945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7913 COUNTY ROAD 385",
            "city": "NEWBERRY",
            "state": "MI",
            "postal_code": "498687508",
            "telephone_number": "906-293-1981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7913 COUNTY ROAD 385",
            "city": "NEWBERRY",
            "state": "MI",
            "postal_code": "498687508",
            "telephone_number": "906-322-1806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTYN",
        "first_name": "DANETTE",
        "middle_name": "LYNN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-22",
        "last_updated": "2021-06-06",
        "certification_date": "2021-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704205351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newberry, MI

Sources for this page

Verify at the official NPI Registry.