Active NPI
Bobbie Shane Martin, PHARMD
- Psychiatric Pharmacist
- Chillicothe, OH
National Provider Identifier
1710266853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric Pharmacist
- License
- 032264202
- Practice address
- 17273 State Route 104
Chillicothe VA Medical Center
Chillicothe, OH 45601-9718 - Phone
- (740) 773-1141
- NPI assigned
- Aug 8, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric Pharmacist | 1835P1300X | 032264202 | OH | Primary |
Addresses
Primary practice location
17273 State Route 104
Chillicothe VA Medical Center
Chillicothe, OH 45601-9718
Mailing address
715 Autumn Dr Unit a
Ada, OH 45810-1830
Phone (419) 634-0776
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 032264202 | OH | MD | Psychiatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312761600000",
"number": "1710266853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "715 AUTUMN DR UNIT A",
"city": "ADA",
"state": "OH",
"postal_code": "458101830",
"telephone_number": "419-634-0776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17273 STATE ROUTE 104",
"address_2": "CHILLICOTHE VA MEDICAL CENTER",
"city": "CHILLICOTHE",
"state": "OH",
"postal_code": "456019718",
"telephone_number": "740-773-1141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "BOBBIE",
"middle_name": "SHANE",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-08-08",
"last_updated": "2011-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1300X",
"taxonomy_group": "",
"desc": "Pharmacist, Psychiatric",
"state": "OH",
"license": "032264202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chillicothe, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.