Individual provider Active NPI

Kimberly Jo Martin, FNP-BC

  • Family Nurse Practitioner
  • Lancaster, PA
National Provider Identifier
1851166201
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP028699 Issued in PA
Practice address
2112 Harrisburg Pike
Suite 312
Lancaster, PA 17601-2644
Phone
(717) 471-2931
NPI assigned
Nov 15, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP028699 PA Primary

Addresses

Primary practice location

2112 Harrisburg Pike
Suite 312
Lancaster, PA 17601-2644

Mailing address

2112 Harrisburg Pike
Ste 312
Lancaster, PA 17601
Phone (717) 471-2931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240216000839 PA Practitioner - Nurse Practitioner 3971947052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lancaster General HospitalGroup PAC ID 1254240039, 520 clinicians

Practice addresses (Care Compare)

2112 Harrisburg Pike
Suite 312
Lancaster, PA 17601-2644
Phone (717) 544-3022

Hospital & facility affiliations

  • Lancaster General Hospital Hospital, Lancaster, PA, CCN 390100
  • Upmc Northwest Hospital, Seneca, PA, CCN 390091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP028699PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lanaster General Hospital CurrentSince Feb 4, 2024 Accepting new patients
Lancaster General Hospital CurrentSince Feb 4, 2024 Accepting new patients
Lancaster General Hospital Current Accepting new patients
Lancaster General Medical Group Past Accepting new patients

Locations

2112 Harrisburg Pike
Ste 312
Lancaster, PA 17601
Phone (717) 544-3022

317 Chestnut St
Quarryville, PA 17566
Phone (717) 544-3555

212 Willow Valley Lakes Dr
#101
Willow Street, PA 17584

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1700006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1851166201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2112 HARRISBURG PIKE",
            "address_2": "STE 312",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "17601",
            "telephone_number": "717-471-2931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2112 HARRISBURG PIKE",
            "address_2": "SUITE 312",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012644",
            "telephone_number": "717-471-2931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KIMBERLY",
        "middle_name": "JO",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-15",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP028699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.