Individual provider Active NPI

Paula B Martin, C.N.S.

  • Adult Psychiatric/Mental Health Clinical Nurse Specialist
  • Saint Louis, MO
National Provider Identifier
1790897130
Registry record updated Jan 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X
License
62550 Issued in MO
Practice address
8745 Litzsinger Dr
Saint Louis, MO 63144-2305
Phone
(314) 288-9720
Fax
(314) 961-4375
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2009

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 062550 MO
Nurse Practitioner 363L00000X 041-318181 IL
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X 62550 MO Primary

Addresses

Primary practice location

8745 Litzsinger Dr
Saint Louis, MO 63144-2305

Mailing address

8745 Litzsinger Dr
Saint Louis, MO 63144-2305
Phone (314) 288-9720

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)
Enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
041-318181ILMDNurse Practitioner
062550MOMDNurse Practitioner
62550MOMDAdult Psychiatric/Mental Health Clinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Geriatric Psychiatry Consultants LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230854400000",
    "number": "1790897130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8745 LITZSINGER DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631442305",
            "telephone_number": "314-288-9720",
            "fax_number": "314-961-4375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8745 LITZSINGER DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631442305",
            "telephone_number": "314-288-9720",
            "fax_number": "314-961-4375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PAULA",
        "middle_name": "B",
        "name_prefix": "Ms.",
        "credential": "C.N.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "062550",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "041-318181",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MO",
            "license": "62550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2009; 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.