Breanna Tyler Martin, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71015633A Issued in IN

Practice address

1312 E Hackberry St
Salem, IN 47167-9604

Phone

(812) 286-0126

NPI assigned

Aug 16, 2024

Last updated

Aug 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fast Pace Medical Clinic PLLCGroup PAC ID 5395881841, 737 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Salem Hospital, Salem, IN, CCN 151314

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fast Pace Medical Clinic PLLC

  • Family Medicine Physician
  • Hanover, IN
  • NPI 1649770769
  Medicare reassignment Care Compare group NPD
• FC Indiana, LLC

  dba First Care Clinics

  • Nurse Practitioner
  • Bedford, IN
  • NPI 1225579063
  Medicare reassignment NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  IN

  Medicare reassignment NPD
• FC Indiana, LLC

  • Rural Health Clinic/Center
  • Bedford, IN
  • NPI 1841911591
  NPD
• Fast Pace Medical Clinic PLLC

  • Rural Health Clinic/Center
  • Chapel Hill, TN
  • NPI 1316602774
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD
• Major Hospital

  • General Acute Care Hospital
  • Shelbyville, IN
  • NPI 1174555692
  NPD (past)

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

• St Vincent Salem Hospital Inc

  • Critical Access Hospital
  • Salem, IN
  • NPI 1427388982
  Care Compare affiliation

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

{
    "created_epoch": "1723766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1861224099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1312 E HACKBERRY ST",
            "city": "SALEM",
            "state": "IN",
            "postal_code": "471679604",
            "telephone_number": "812-286-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 E HACKBERRY ST",
            "city": "SALEM",
            "state": "IN",
            "postal_code": "471679604",
            "telephone_number": "812-286-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "BREANNA",
        "middle_name": "TYLER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015633A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Louisville Optometric Centers, III PSC (VisionFirst)
• Louisville Optometric Centers, III PSC (VisionFirst)
• Main Street Dental LLC
• Rebecca Cauble Marshall, R.PH.
• Martin F Kennedy DDS PC
• Lindsee Martinez
• Danielle McIntyre
• Medi-Ride, Inc.
• Mid America Clinical Laboratories, LLC
• Damien Miller

• Family Nurse Practitioner in Salem, IN
• Providers in Salem, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.