Roberta Jo Martin, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

051300115 Issued in IL

Practice address

1311 N State Route 48
Decatur, IL 62526-3701

Phone

(217) 429-1988

Fax

(217) 429-9577

NPI assigned

Aug 31, 2020

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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 and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Decatur, IL
  • NPI 1730195181
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1598832000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598832000000",
    "number": "1871107698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 N KICKAPOO ST",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626562139",
            "telephone_number": "217-871-4907",
            "fax_number": "217-429-9577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 N STATE ROUTE 48",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263701",
            "telephone_number": "217-429-1988",
            "fax_number": "217-429-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ROBERTA",
        "middle_name": "JO",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-31",
        "last_updated": "2020-08-31",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051.300115",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "IL",
            "license": "051300115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marshall F. Brustein M.D.
• Gloria J Marshall
• Amy E Marsili, L.C.S.W.
• Lakyla Martin
• Rebecca Lynn Martin, PA-C
• Susan K Martin
• Amanda Martz
• Angie Mason, RBT
• Anita F Mason, MA; LMFT
• Fidel Mata, P.A.

• Pharmacist in Decatur, IL
• Providers in Decatur, IL by specialty
• Pharmacist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; 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.