Active NPI
Michele Marie Martin, MS, CCLS
- Specialist
- Austin, TX
National Provider Identifier
1710669171
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 3688
- Practice address
- 3501 Red River St
Austin, TX 78705-1831 - Phone
- (512) 461-3638
- NPI assigned
- Aug 4, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | 3688 | TX | Primary |
Addresses
Primary practice location
3501 Red River St
Austin, TX 78705-1831
Mailing address
5316 Cardinal Flower CV
Spicewood, TX 78669-6969
Phone (512) 461-3638
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3688 | TX | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691107200000",
"number": "1710669171",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5316 CARDINAL FLOWER CV",
"city": "SPICEWOOD",
"state": "TX",
"postal_code": "786696969",
"telephone_number": "512-461-3638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3501 RED RIVER ST",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787051831",
"telephone_number": "512-461-3638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "MICHELE",
"middle_name": "MARIE",
"credential": "MS, CCLS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-08-04",
"last_updated": "2023-08-04",
"certification_date": "2023-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "TX",
"license": "3688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.