Active NPI
Andrea Christine Martin
- Physician Assistant
- Saint Louis, MO
National Provider Identifier
1740523885
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2013007998
- Practice address
- 3009 N Ballas Rd
Ste 100B
Saint Louis, MO 63131-2322 - Phone
- (314) 432-1111
- Fax
- (314) 432-6308
- NPI assigned
- Mar 27, 2013
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2013007998 | MO | Primary |
Addresses
Primary practice location
3009 N Ballas Rd
Ste 100B
Saint Louis, MO 63131-2322
Mailing address
3009 N Ballas Rd
Ste 100B
Saint Louis, MO 63131-2322
Phone (314) 432-1111
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2013007998 | MO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1364342400000",
"number": "1740523885",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3009 N BALLAS RD",
"address_2": "STE 100B",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312322",
"telephone_number": "314-432-1111",
"fax_number": "314-432-6308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3009 N BALLAS RD",
"address_2": "STE 100B",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631312322",
"telephone_number": "314-432-1111",
"fax_number": "314-432-6308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ANDREA",
"middle_name": "CHRISTINE",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-27",
"last_updated": "2013-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2013007998",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.