Active NPI
Abraham Andrew Martinez
- Pharmacist
- Leavenworth, KS
National Provider Identifier
1770747370
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 30108
- Practice address
- 16780 Renesland Rd
Leavenworth, KS 66048-9485 - Phone
- (913) 772-8212
- NPI assigned
- Jul 12, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 30108 | TX | Primary |
Addresses
Primary practice location
16780 Renesland Rd
Leavenworth, KS 66048-9485
Mailing address
16780 Renesland Rd
Leavenworth, KS 66048-9485
Phone (913) 772-8212
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30108 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215820800000",
"number": "1770747370",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16780 RENESLAND RD",
"city": "LEAVENWORTH",
"state": "KS",
"postal_code": "660489485",
"telephone_number": "913-772-8212"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16780 RENESLAND RD",
"city": "LEAVENWORTH",
"state": "KS",
"postal_code": "660489485",
"telephone_number": "913-772-8212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "ABRAHAM",
"middle_name": "ANDREW",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-12",
"last_updated": "2008-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "TX",
"license": "30108",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Leavenworth, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.