Kimberly Anne Oglesby Martin, APRN-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209.014904 Issued in IL

Practice address

701 N 1St St
Springfield, IL 62781-1069

Phone

(217) 788-3000

NPI assigned

Sep 22, 2016

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1710436472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 N MARION ST",
            "city": "MOUNT PULASKI",
            "state": "IL",
            "postal_code": "625481069",
            "telephone_number": "217-971-4101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N 1ST ST",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627811069",
            "telephone_number": "217-788-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3132 Old Jacksonville Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "IL",
            "postal_code": "627047401",
            "country_code": "US",
            "telephone_number": "217-588-2600",
            "fax_number": "217-862-0904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KIMBERLY",
        "middle_name": "ANNE OGLESBY",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-22",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209.014904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "041.386754",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marshmallows Hope Nonprofit Organization
• Emily Suzanne Martin, FNP-BC
• Jennifer Mason Martin, PT
• Jongjin Anne Martin, M.D.
• Katharine Martin, LCPC
• Paige Nicole Martin
• Peter Martin, MD
• Richard A Martin, LCSW
• Christopher Martinek, M.D.
• Lorena Carolina Martinez King, MD

• Family Nurse Practitioner in Springfield, IL
• Providers in Springfield, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.