Individual provider Active NPI

Krystal Martin, RN

  • Registered Nurse
  • Milwaukee, WI
National Provider Identifier
1811505191
Registry record updated Jul 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
197065-30 Issued in WI
Practice address
6974 N 43Rd St Unit C
Milwaukee, WI 53209-2270
Phone
(262) 389-6270
NPI assigned
Jul 22, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 197065-30 WI Primary

Addresses

Primary practice location

6974 N 43Rd St Unit C
Milwaukee, WI 53209-2270

Mailing address

6974 N 43Rd St Unit C
Milwaukee, WI 53209-2270
Phone (262) 389-6270

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
197065-30WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1595376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1811505191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6974 N 43RD ST UNIT C",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092270",
            "telephone_number": "262-389-6270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6974 N 43RD ST UNIT C",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532092270",
            "telephone_number": "262-389-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KRYSTAL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-22",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "197065-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.