Individual provider Active NPI

Joshua Martin, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1720564479
Registry record updated Jul 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP138055 Issued in TX
Practice address
8308 Snow Egret Way
Fort Worth, TX 76118-7613
Phone
(318) 623-6941
NPI assigned
Jul 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP138055 TX Primary

Addresses

Primary practice location

8308 Snow Egret Way
Fort Worth, TX 76118-7613

Mailing address

8308 Snow Egret Way
Fort Worth, TX 76118-7613
Phone (318) 623-6941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20210907003618 LA Practitioner - Nurse Practitioner 3971847542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Service District 1 of East Baton Rouge ParishGroup PAC ID 0941191902, 44 clinicians

Practice addresses (Care Compare)

19900 Old Scenic Hwy
Suite Fastlane
Zachary, LA 70791-7368
Phone (225) 570-2618

Hospital & facility affiliations

  • Lane Regional Medical Center Hospital, Zachary, LA, CCN 190020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP138055TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Service District 1 of East Baton Rouge Parish Current Accepting new patients
Hospital Service District 1 of East Baton Rouge Parish CurrentSince Aug 16, 2021 Accepting new patients
Hospital Service District 1 of East Baton Rouge Parish CurrentSince Aug 16, 2021 Accepting new patients
Hospital Service District 1 of East Baton Rouge Parish Past Accepting new patients

Locations

19900 Old Scenic Hwy
Ste E
Zachary, LA 70791
Phone (225) 570-2618

2335 Church St
Zachary, LA 70791
Phone (225) 654-3607

2335 Church St
Ste E
Zachary, LA 70791
Phone (225) 570-2489

6300 Main St
Zachary, LA 70791
Phone (225) 570-2618

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531699200000",
    "number": "1720564479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8308 SNOW EGRET WAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761187613",
            "telephone_number": "318-623-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8308 SNOW EGRET WAY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761187613",
            "telephone_number": "318-623-6941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOSHUA",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-16",
        "last_updated": "2018-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138055",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.