Nancy Marthakis, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5101020834 Issued in MI

Practice address

3355 Eagle Park Dr NE Ste 103
Grand Rapids, MI 49525-7004

Phone

(616) 942-7400

Fax

(616) 942-7405

NPI assigned

Jun 11, 2012

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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

• Iah of Michigan, PLLC

  • Family Medicine Physician
  • Troy, MI
  • NPI 1578969705

  Internal Medicine

  NPD (past)

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1780946236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8540 105TH AVE",
            "city": "STANWOOD",
            "state": "MI",
            "postal_code": "493469764",
            "telephone_number": "219-763-8112",
            "fax_number": "219-764-6348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3355 EAGLE PARK DR NE STE 103",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257004",
            "telephone_number": "616-942-7400",
            "fax_number": "616-942-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTHAKIS",
        "first_name": "NANCY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "02004027A",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101020834",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780946236",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Martell, DPT
• Mallory Martens, PA
• Sandra Martens
• Vaughan Elaine Martens
• Martha Velting Therapy
• Candice Olivia Marthaler, OTRL
• Deneb D Martin Armenteros
• Deborah Sue Martin-Gill, M.S.W.
• Alex Robert Martin, D.O.
• Alexander Martin

• Internal Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.