Individual provider Active NPI

Connor Martin, CNP

  • Pediatric Nurse Practitioner
  • The Colony, TX
National Provider Identifier
1821876921
Registry record updated Sep 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1136682 Issued in TX
Practice address
5151 Hwy 121
The Colony, TX 75056-2601
Phone
(214) 488-5437
Fax
(214) 488-5438
NPI assigned
Sep 19, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0200X 1136682 TX Primary

Addresses

Primary practice location

5151 Hwy 121
The Colony, TX 75056-2601

Mailing address

11721 Marion Rd
Sanger, TX 76266-3288
Phone (940) 536-8165

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
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1136682TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Health PM Urgent Care, PLLC Single Specialty PastSince Sep 24, 2023 Accepting new patients
Saveritt Pediatrics PLLC Single Specialty Past Accepting new patients

Organizations & group practices 2

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": "1695081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695081600000",
    "number": "1821876921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11721 MARION RD",
            "city": "SANGER",
            "state": "TX",
            "postal_code": "762663288",
            "telephone_number": "940-536-8165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 HWY 121",
            "city": "THE COLONY",
            "state": "TX",
            "postal_code": "750562601",
            "telephone_number": "214-488-5437",
            "fax_number": "214-488-5438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CONNOR",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-09-19",
        "last_updated": "2023-09-19",
        "certification_date": "2023-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1136682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in The Colony, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; 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.