Individual provider Active NPI

Jeffery Merle Martin, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Phoenix, AZ
National Provider Identifier
1811949563
Registry record updated Feb 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
28341 Issued in AZ
Practice address
901 E Willetta St
Room 2503
Phoenix, AZ 85006-2727
Phone
(602) 239-5166
Fax
(602) 239-2307
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 28341 AZ Primary

Addresses

Primary practice location

901 E Willetta St
Room 2503
Phoenix, AZ 85006-2727

Mailing address

37 W Sierra Vista Dr
Phoenix, AZ 85013-1200
Phone (602) 957-8767

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
28341AZMDNeonatal-Perinatal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486598400000",
    "number": "1811949563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 W SIERRA VISTA DR",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850131200",
            "telephone_number": "602-957-8767",
            "fax_number": "602-265-5489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 E WILLETTA ST",
            "address_2": "ROOM 2503",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062727",
            "telephone_number": "602-239-5166",
            "fax_number": "602-239-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JEFFERY",
        "middle_name": "MERLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2017-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "AZ",
            "license": "28341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2017; 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.