Individual provider Active NPI

Cynthia Jill Martinez, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1790438935
Registry record updated Nov 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
25739 Issued in SC
Practice address
2601 Rosewood Dr
Columbia, SC 29205-3745
Phone
(803) 782-4051
NPI assigned
Jan 28, 2022
Last updated
Nov 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 25739 SC Primary

Addresses

Primary practice location

2601 Rosewood Dr
Columbia, SC 29205-3745

Mailing address

PO Box 749306
Atlanta, GA 30374-9306

Other practice location 1

1221 21st Ave N
Myrtle Beach, SC 29577-7402
Phone (843) 626-9379

Other practice location 2

9201 E Mountain View Rd Ste 220
Scottsdale, AZ 85258-5172
Phone (480) 273-4001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220526002033 SC Practitioner - Nurse Practitioner 4082092366 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novant Health Urgent Cares LLCGroup PAC ID 8628502598, 183 clinicians

Practice addresses (Care Compare)

6167 Braided Mane Pass SW
Aiken, SC 29803-7839
Phone (803) 648-1464

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
25739SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Novant Health Urgent Cares LLC CurrentSince Nov 1, 2024 Accepting new patients

Locations

6167 Braided Mane Pass SW
Aiken, SC 29803
Phone (803) 502-1484

100 Jimmy Love Ln
Columbia, SC 29212
Phone (803) 731-4055

2601 Rosewood Dr
Columbia, SC 29205
Phone (803) 782-4051

1221 21st Ave N
Myrtle Beach, SC 29577
Phone (843) 626-9379

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1643328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1790438935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749306",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 ROSEWOOD DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292053745",
            "telephone_number": "803-782-4051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 21st Ave N",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295777402",
            "country_code": "US",
            "telephone_number": "843-626-9379",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9201 E Mountain View Rd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852585172",
            "country_code": "US",
            "telephone_number": "480-273-4001",
            "fax_number": "480-907-2646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "CYNTHIA",
        "middle_name": "JILL",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-28",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "25739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.