Kenneth Martin, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS4318 Issued in FL

Practice address

9270 Bay Plaza Blvd
Suite 640
Tampa, FL 33619-4499

Phone

(813) 621-0130

Fax

(813) 621-7916

NPI assigned

Sep 16, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429747200000",
    "number": "1790770600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9270 BAY PLAZA BLVD",
            "address_2": "SUITE 640",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194499",
            "telephone_number": "813-621-0130",
            "fax_number": "813-621-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9270 BAY PLAZA BLVD",
            "address_2": "SUITE 640",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336194499",
            "telephone_number": "813-621-0130",
            "fax_number": "813-621-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KENNETH",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-16",
        "last_updated": "2015-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS4318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049619700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Anthony Martin, PA-C
• Julie Goddard Martin, LMHC
• Julie Nicole Martin, P.T.
• Kaleeah J Martin
• Kara Martin
• Kerri Jane Martin, OTR, CBIS
• Latoya Martin, ARNP
• Lisa J Martin, PH.D.
• Logan Lee Martin, MD
• Lucia Martin, LMHC

• Family Medicine Physician in Tampa, FL
• Providers in Tampa, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2015; 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.