Samuel Keith Martin, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

1101001434 Issued in VA

Practice address

4135 Franklin Rd
Roanoke, VA 24018-5703

Phone

(540) 776-2933

Fax

(540) 776-2932

NPI assigned

Feb 3, 2007

Last updated

Nov 26, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• National Optical

  • Optician
  • Roanoke, VA
  • NPI 1982863684
  Authorized official Same address or phone

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1730227349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4135 FRANKLIN RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240185703",
            "telephone_number": "540-776-2933",
            "fax_number": "540-776-2932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 FRANKLIN RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240185703",
            "telephone_number": "540-776-2933",
            "fax_number": "540-776-2932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SAMUEL",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "VA",
            "license": "1101001434",
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NC",
            "license": "1129",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaiya S Martin, BCBA, LBA
• Kendal Martin, DPT
• Laurel E Martin, LPC, LMFT
• Mark Martin, LCSW
• Patricia A Martin
• Kelly Jo Martindale, LMT
• German Martinez, PA-C
• Lauren Courtney Martinez, AGACNP- BC
• Melissa Wray Martinez, FNP
• John Michael Martino, MD

• Optician in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Optician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.