Patti L Martin, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

209000493 Issued in IL

Practice address

3333 W Deyoung St
Marion, IL 62959-5884

Phone

(618) 998-7000

NPI assigned

May 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

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.

• Marion Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Marion, IL
  • NPI 1679870513
  NPD (past)
• New Century Physicians of Southern Illinois Inc

  • Emergency Medicine Physician
  • Marion, IL
  • NPI 1922007533
  NPD (past)
• Sterling Emergency Physicians of Illinois, S.C

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1295975837

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213574400000",
    "number": "1699723254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 HEMPSTEAD STATION DR",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454295164",
            "telephone_number": "800-875-0136",
            "fax_number": "937-619-4231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595884",
            "telephone_number": "618-998-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PATTI",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-05",
        "last_updated": "2008-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209000493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE HEARTLAND",
            "identifier": "P00317454",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Marissa Martin-Leitzen, PHARM.D.
• Amanda Sue Martin, COTAL
• David A Martin, OTR/L
• Jennifer Martin, LCPC
• Michele Marie Martin, RD
• Steven Lee Martinez, PA-C
• Tameeka Marvin
• Serhiy Maslovsky, PA
• Rachel Lauren Massa, M.A. CCC-SLP
• Masterful Therapy

• Nurse Practitioner in Marion, IL
• Providers in Marion, IL by specialty
• Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.