Kelly C. Martin, APNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

348033 Issued in WI

Practice address

1458 Horizon Blvd Ste 150
Mount Pleasant, WI 53406-5790

Phone

(262) 632-1100

NPI assigned

Sep 3, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Kelly C. Clark Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753315200000",
    "number": "1881842938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1458 HORIZON BLVD STE 150",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065790",
            "telephone_number": "262-632-1100",
            "fax_number": "262-632-1101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1458 HORIZON BLVD STE 150",
            "city": "MOUNT PLEASANT",
            "state": "WI",
            "postal_code": "534065790",
            "telephone_number": "262-632-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4666 S 35th St",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "WI",
            "postal_code": "532212159",
            "country_code": "US",
            "telephone_number": "414-306-6315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KELLY",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "APNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2025-07-24",
        "certification_date": "2025-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "WI",
            "license": "348033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CLARK",
            "middle_name": "C.",
            "prefix": "MS.",
            "credential": "APNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Karen Diane Marano, RDH
• Mark E Decheck MD SC
• Robert Marsh, DNP, CRNA, APNP
• Tiana Marshall
• Katie Martin
• Lindsey Martinez, MOTRL
• James Dean Mataczynski, MD
• Emily M Matson, PTA
• Katrina Kiefer Matthias, LPC
• Carrie Mattie-Jensen

• Acute Care Nurse Practitioner in Mount Pleasant, WI
• Providers in Mount Pleasant, WI by specialty
• Acute Care Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2025; 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.