Active NPI
Roberto Martinez, M.D.
- General Practice Physician
- Yazoo City, MS
National Provider Identifier
1821299603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- 14370
- Practice address
- 2225 Haley Barbour Pkwy
Yazoo City, MS 39194-4796 - Phone
- (662) 716-1020
- Fax
- (662) 716-1053
- NPI assigned
- May 30, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | 14370 | PR | Primary |
Addresses
Primary practice location
2225 Haley Barbour Pkwy
Yazoo City, MS 39194-4796
Mailing address
145 Bradshaw Crossing
Canton, MS 39046
Phone (601) 605-0984
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14370 | PR | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821299603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 BRADSHAW CROSSING",
"city": "CANTON",
"state": "MS",
"postal_code": "39046",
"telephone_number": "601-605-0984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 HALEY BARBOUR PKWY",
"city": "YAZOO CITY",
"state": "MS",
"postal_code": "391944796",
"telephone_number": "662-716-1020",
"fax_number": "662-716-1053"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTINEZ",
"first_name": "ROBERTO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PR",
"license": "14370",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yazoo City, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.