Chanel St Martin, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PACN1 Issued in FL

Practice address

2385 N Lecanto Hwy
Lecanto, FL 34461-9677

Phone

(352) 527-6888

NPI assigned

Aug 29, 2020

Last updated

Mar 12, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric and Internal Medicine Specialists Inc

  dba PedIM Healthcare

  • Family Medicine Physician
  • Lecanto, FL
  • NPI 1396805115
  NPD (past)
• Pedim Outreach and Specialty Clinic LLC

  • Family Medicine Physician
  • Lecanto, FL
  • NPI 1558128819
  NPD (past)
• Pedim Outreach and Specialty Clinic LLC

  dba MD Sleep Care

  • Sleep Disorder Diagnostic Clinic/Center
  • Lecanto, FL
  • NPI 1851848097
  NPD (past)

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

{
    "created_epoch": "1598659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741737600000",
    "number": "1649883570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1990 N PROSPECT AVE",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344619792",
            "telephone_number": "352-527-6888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2385 N LECANTO HWY",
            "city": "LECANTO",
            "state": "FL",
            "postal_code": "344619677",
            "telephone_number": "352-527-6888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3580 E Gulf To Lake Hwy",
            "address_purpose": "LOCATION",
            "city": "Inverness",
            "state": "FL",
            "postal_code": "344533207",
            "country_code": "US",
            "telephone_number": "352-527-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2805 W Flare Ln",
            "address_purpose": "LOCATION",
            "city": "Lecanto",
            "state": "FL",
            "postal_code": "34461",
            "country_code": "US",
            "telephone_number": "352-527-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1982 N Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Lecanto",
            "state": "FL",
            "postal_code": "344619792",
            "country_code": "US",
            "telephone_number": "352-527-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3565 E Suzie Ln",
            "address_purpose": "LOCATION",
            "city": "Inverness",
            "state": "FL",
            "postal_code": "344523250",
            "country_code": "US",
            "telephone_number": "352-527-6888",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1990 N Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Lecanto",
            "state": "FL",
            "postal_code": "344619792",
            "country_code": "US",
            "telephone_number": "352-527-6888",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ST MARTIN",
        "first_name": "CHANEL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-29",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "TPPA184",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PR",
            "license": "000758-PA",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8551",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PACN1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kate H Smith, LCSW
• Terri Lynette Smith, D.O.
• Valerie Lynn Viola Snapp, ARNP
• Eileen Snyder, NURSE PRACTITIONER
• Patricia Kathleen Spitzer, PA
• Dacelin St Martin, MD
• Beena M Stanley, M.D.
• Keely M Staten, PA-C
• David Thomas John Stimson, PHARMD
• David Strang

• Physician Assistant in Lecanto, FL
• Providers in Lecanto, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; 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.