Individual provider Active NPI

Kevin Samuel Martin, FNP

  • Family Nurse Practitioner
  • Washington, DC
National Provider Identifier
1881978229
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5005307 Issued in NC
Practice address
1310 Southern Ave SE
Washington, DC 20032-4623
Phone
(252) 933-0005
NPI assigned
Oct 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5005307 NC Primary
Family Nurse Practitioner 363LF0000X 092767-23 NH

Addresses

Primary practice location

1310 Southern Ave SE
Washington, DC 20032-4623

Mailing address

3710 University Dr Ste 330
Durham, NC 27707-6204
Phone (252) 933-0005

Other practice location 1

590 Court St
Keene, NH 03431-1719
Phone (603) 354-5400

Other practice location 2

580 Court St
Keene, NH 03431-1718
Phone (603) 354-5400

Other identifiers 2

IdentifierTypeStateIssuer
7005432MedicaidNC
168G5OtherBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151005003005 VA Practitioner - Nurse Practitioner 7214100676 Reassigns benefits to 1 organization
I20240108000469 NH Practitioner - Nurse Practitioner 7214100676 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians
Dartmouth-Hitchcock ClinicGroup PAC ID 4183537509, 1,445 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

580 Court St
Keene, NH 03431-1718
Phone (603) 354-5400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Dec 26, 2023 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 29, 2025 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jan 14, 2026 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Aug 29, 2025 Accepting new patients
Cheshire Medical Center CurrentSince Jan 14, 2026 Accepting new patients

Locations

580 Court St
Keene, NH 03431
Phone (603) 354-5454

590 Court St
Keene, NH 03431
Phone (603) 354-5454

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

Organizations & group practices 8

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 3

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": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1881978229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 UNIVERSITY DR STE 330",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277076204",
            "telephone_number": "252-933-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 SOUTHERN AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324623",
            "telephone_number": "252-933-0005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "590 Court St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034311719",
            "country_code": "US",
            "telephone_number": "603-354-5400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "580 Court St",
            "address_purpose": "LOCATION",
            "city": "Keene",
            "state": "NH",
            "postal_code": "034311718",
            "country_code": "US",
            "telephone_number": "603-354-5400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KEVIN",
        "middle_name": "SAMUEL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-04",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005307",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NH",
            "license": "092767-23",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005432",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "168G5",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.