Angelique M Martin, L.D.

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

970 Issued in OK

Practice address

4140 W Memorial Rd Ste 321
Oklahoma City, OK 73120

Phone

(405) 748-4726

Fax

(405) 607-8497

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Angelique Nagel Other name

Medicare fee-for-service enrollment

Enrolled in OK, AR2 enrollments

Enrollment records 2

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Perinatal Center, PLLCGroup PAC ID 1153302120, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: perinatalcenterofoklahoma.angeliquemartin@111704.advancedmd-direct.com

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.

• The Perinatal Center, PLLC

  • Maternal & Fetal Medicine Physician
  • Oklahoma City, OK
  • NPI 1942217815

  AR

  Medicare reassignment Care Compare group
• Mercy Hospital Oklahoma City, Inc

  • Diagnostic Radiology Physician
  • Yukon, OK
  • NPI 1730326406
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578614400000",
    "number": "1669570552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4140 W MEMORIAL RD STE 321",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208300",
            "telephone_number": "405-748-4726",
            "fax_number": "405-607-8497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4140 W MEMORIAL RD STE 321",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "73120",
            "telephone_number": "405-748-4726",
            "fax_number": "405-607-8497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3435 NW 56th St Ste 303",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731124414",
            "country_code": "US",
            "telephone_number": "405-606-2850",
            "fax_number": "405-606-2855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3501 24th Ave NW Ste 101",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730696665",
            "country_code": "US",
            "telephone_number": "405-801-2542",
            "fax_number": "405-801-2564",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2000 S Wheeling Ave Ste 920",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741045649",
            "country_code": "US",
            "telephone_number": "918-947-5980",
            "fax_number": "918-746-2230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5414 W Pinnacle Pointe Dr Ste 300",
            "address_purpose": "LOCATION",
            "city": "Rogers",
            "state": "AR",
            "postal_code": "727588956",
            "country_code": "US",
            "telephone_number": "479-268-4979",
            "fax_number": "479-268-4998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ANGELIQUE",
        "middle_name": "M",
        "credential": "L.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-01-10",
        "certification_date": "2020-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "AR",
            "license": "1796",
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "OK",
            "license": "970",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100166870A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LD LICENSE",
            "identifier": "970",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELIQUE",
            "last_name": "NAGEL",
            "credential": "L.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Allie Marie Martin
• Amanda Martin, M.D.
• Amy L Martin, NP
• Amy Sue Martin, LCSW
• Andrea N Martin
• Angie Jeanette Martin, PTA
• Ann Marie Martin
• Bradley John Martin, RN, CNS
• Brandy Dawn Martin, C-PRSS
• Cadence Martin

• Registered Dietitian in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Registered Dietitian in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.