Amy Marie Martin, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3013704 Issued in KY

Practice address

1802 E 10TH St
Jeffersonville, IN 47130-6016

Phone

(812) 288-2488

Fax

(812) 288-6603

NPI assigned

Aug 21, 2019

Last updated

Dec 26, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in KY, IN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Clark Medical Group LLCGroup PAC ID 3971879354, 21 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

83.73 of 100Reported as group

Quality

73.7

Promoting interoperability

100

Improvement activities

40

Cost

60.18

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: amartin246595@direct.nortonhealthcare.org

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.

• North Clark Medical Group LLC

  • General Practice Physician
  • Jeffersonville, IN
  • NPI 1376095711

  KY

  Medicare reassignment Care Compare group NPD
• Norton Hospitals Inc

  dba Norton Cancer Institute

  • Multi-Specialty Clinic/Center
  • Louisville, KY
  • NPI 1073568879

  IN, Psychiatric/Mental Health

  Medicare reassignment NPD
• Seven Counties Services, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Louisville, KY
  • NPI 1598793671
  Medicare reassignment NPD
• Norton Hospitals, Inc

  dba Norton Pain Management Associates

  • Pain Medicine Physician
  • Louisville, KY
  • NPI 1548152242
  NPD
• Courtland, LLC

  dba The Growth Center for Counseling and Wellness

  • Psychiatry Physician
  • New Albany, IN
  • NPI 1417154584
  NPD (past)

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735171200000",
    "number": "1770130122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776347",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776347",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 E 10TH ST",
            "city": "JEFFERSONVILLE",
            "state": "IN",
            "postal_code": "471306016",
            "telephone_number": "812-288-2488",
            "fax_number": "812-288-6603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2105 Crums Ln",
            "address_purpose": "LOCATION",
            "city": "Shively",
            "state": "KY",
            "postal_code": "402164231",
            "country_code": "US",
            "telephone_number": "502-589-8915",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4925 Charlestown Rd",
            "address_purpose": "LOCATION",
            "city": "New Albany",
            "state": "IN",
            "postal_code": "471509426",
            "country_code": "US",
            "telephone_number": "812-941-9200",
            "fax_number": "812-941-9205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3991 Dutchmans Ln Ste 405",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402074723",
            "country_code": "US",
            "telephone_number": "502-899-2673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "AMY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-21",
        "last_updated": "2024-12-26",
        "certification_date": "2024-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71011592A",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3013704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "IN3604072",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300061493",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100619340",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy.martin@nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "3991 Dutchmans Ln Ste 405",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402074723",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Courtney Nicole Marcum, RBT
• Kennedie Margarida, RBT
• Christina Dawn Marshall, RBT
• Maggie Marshall
• Nathan Andrew Marshall, PT
• Mackenzie Martin, RBT
• Troy Harold Martin, DMD
• Antonia Martinez, RBT
• Ashley M Martinez
• Muhammad I Masroor, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Jeffersonville, IN
• Providers in Jeffersonville, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2024; 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.