Jesse Martin, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APN.1000691-NP Issued in CO

Practice address

4112 Outlook Blvd Ste 2552ND
Pueblo, CO 81008-1667

Phone

(719) 553-2235

NPI assigned

Apr 10, 2025

Last updated

Apr 10, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Colorado Clinic PCGroup PAC ID 4284524067, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jesse.martin.1@21306.direct.athenahealth.com
• Direct secure messaging: jesse.martin@krogerhealth.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southern Colorado Clinic PC

  • Clinic/Center
  • Pueblo, CO
  • NPI 1285613554
  Medicare reassignment Care Compare group NPD
• The Little Clinic of Colorado, LLC

  • Family Nurse Practitioner
  • Highlands Ranch, CO
  • NPI 1538354568
  Medicare reassignment NPD

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

{
    "created_epoch": "1744243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1720873854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4112 OUTLOOK BLVD STE 2552ND",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081667",
            "telephone_number": "719-553-2235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4112 OUTLOOK BLVD STE 2552ND",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810081667",
            "telephone_number": "719-553-2235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JESSE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-10",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.1000691-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greer Marshall
• Carolyn Nichole Marsters, R.N
• Anne Martic, DPT, PT
• Becky Joann Martin, PTA
• Beth Michelle Martin
• Kayla Martin
• Mary Martin, LPC
• Rachelle Martin
• Shirley Martin
• Tammy Martin

• Family Nurse Practitioner in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Family Nurse Practitioner in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.