Individual provider Active NPI

Martha A Jones, NP

  • Pediatric Nurse Practitioner
  • Portsmouth, VA
National Provider Identifier
1821032079
Registry record updated Nov 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024166854 Issued in VA
Practice address
3300 Academy Ave
Portsmouth, VA 23703-3205
Phone
(757) 483-6404
Fax
(757) 483-0737
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024166854 VA Primary

Addresses

Primary practice location

3300 Academy Ave
Portsmouth, VA 23703-3205

Mailing address

2 Ebb Tide LNDG
Poquoson, VA 23662-1334
Phone (757) 868-0123

Other identifiers 1

IdentifierTypeStateIssuer
010261121MedicaidVA

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
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Churchland Psychiatric Associates PC PastSince Jul 1, 1990 Accepting new patients
Childrens Specialty Group PLLC Past Accepting new patients
Riverside Physician Services Inc Past Accepting new patients

Organizations & group practices 3

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417132800000",
    "number": "1821032079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 EBB TIDE LNDG",
            "city": "POQUOSON",
            "state": "VA",
            "postal_code": "236621334",
            "telephone_number": "757-868-0123",
            "fax_number": "757-483-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 ACADEMY AVE",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237033205",
            "telephone_number": "757-483-6404",
            "fax_number": "757-483-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JONES",
        "first_name": "MARTHA",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2014-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024166854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010261121",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2014; 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.