Nicole Joanne Martinez

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

2145 N Fairfield Rd Ste 100
Beavercreek, OH 45431-2783

Phone

(937) 558-3900

NPI assigned

Mar 25, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1648166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1821748559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2145 N FAIRFIELD RD STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312783",
            "telephone_number": "937-558-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2145 N FAIRFIELD RD STE 100",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312783",
            "telephone_number": "937-558-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "319-356-3396",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTINEZ",
        "first_name": "NICOLE",
        "middle_name": "JOANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-25",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IA",
            "license": "R-12687",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Mantz
• Leanna Elaine Manuel, PSY.D.
• Maple Tree Cancer Alliance
• Kaitlyn Elizabeth Marker
• Gabrielle Markley
• Amy Mason, OT
• Timothy Mason, OD
• Judith Marie Masset-Brown, MD
• Rachel Marie Mast, D.O.
• Dale Eugene Mateer, DDS

• Student in an Organized Health Care Education/Training Program in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.