Individual provider Active NPI

Tanya Mae Martin, RN, BSN

  • Registered Nurse
  • Springfield, OR
National Provider Identifier
1669293056
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
201042041 Issued in OR
Practice address
1050 10TH St
Springfield, OR 97477-4003
Phone
(541) 744-4131
Fax
(541) 744-4822
NPI assigned
Oct 18, 2024
Last updated
Oct 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 201042041 OR Primary

Addresses

Primary practice location

1050 10TH St
Springfield, OR 97477-4003

Mailing address

1050 10TH St
Springfield, OR 97477-4003
Phone (541) 744-4131

Other practice location 1

2109 J St
Springfield, OR 97477-4334
Phone (541) 744-6395

Other practice location 2

7345 Thurston Rd
Springfield, OR 97478-7202
Phone (541) 744-6411

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
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
201042041ORMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1729209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1669293056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 10TH ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774003",
            "telephone_number": "541-744-4131",
            "fax_number": "541-744-4822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 10TH ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974774003",
            "telephone_number": "541-744-4131",
            "fax_number": "541-744-4822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2109 J St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974774334",
            "country_code": "US",
            "telephone_number": "541-744-6395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7345 Thurston Rd",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974787202",
            "country_code": "US",
            "telephone_number": "541-744-6411",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "TANYA",
        "middle_name": "MAE",
        "credential": "RN, BSN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-18",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201042041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2024; 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.