Individual provider Active NPI

Wanda Joy Martin, MS

  • Audiologist
  • Lexington, KY
National Provider Identifier
1881787398
Registry record updated Jul 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
100867 Issued in KY
Practice address
1221 S Broadway
Lexington, KY 40504-2701
Phone
(859) 258-4371
Fax
(859) 258-4326
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X KY-0104 KY
Audiologist 231H00000X 100867 KY Primary

Addresses

Primary practice location

1221 S Broadway
Lexington, KY 40504-2701

Mailing address

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-6200

Other identifiers 1

IdentifierTypeStateIssuer
70001045MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100317000695 KY Practitioner - Qualified Audiologist 9830239748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Lexington Clinic PSCGroup PAC ID 3476457532, 329 clinicians

Practice addresses (Care Compare)

1221 S Broadway
Lexington, KY 40504-2701
Phone (859) 258-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0104KYMDClinical Social Worker
100867KYMDAudiologist
KY-0104KYMDAudiologist-Hearing Aid Fitter

Practice roles

OrganizationSpecialtyStatusNew patients
Bluegrass Hearing Institute, PSC Audiologist Current Accepting new patients
Bluegrass Ear Nose & Throat Clinic Audiologist CurrentSince Apr 7, 2014 Accepting new patients

Locations

225 Hospital Dr
Ste 265
Winchester, KY 40391
Phone (859) 737-8482

225 Hospital Dr
Winchester, KY 40391
Phone (859) 737-8528

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: wanda.martin.1@13059.direct.athenahealth.com

Organizations & group practices 3

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": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657756800000",
    "number": "1881787398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-6200",
            "fax_number": "859-258-6203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 S BROADWAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405042701",
            "telephone_number": "859-258-4371",
            "fax_number": "859-258-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "WANDA",
        "middle_name": "JOY",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "KY",
            "license": "KY-0104",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KY",
            "license": "100867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70001045",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.