Robert Martin, M.D.
Individual provider Active NPI Cardiovascular Disease Physician · Newport, TN
NPI 1891785374 · NPPES record last updated Jan 21, 2019
Key facts
- NPI
- 1891785374
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 15406 (TN)
- Practice address
- 434 4TH St Ste 305
Newport, TN 37821-3735 - Phone
- (865) 647-5800
- Fax
- (865) 647-5979
- NPI assigned
- Oct 25, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050801000814 | TN | Practitioner - Cardiovascular Disease (Cardiology) |
6103854138 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15406 | TN | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Summit Medical Group, PLLC | Current |
Accepting new patients | |
| Summit Medical Group, PLLC | Current |
Accepting new patients | |
| Cocke County Hma LLC | Past | Accepting new patients | |
| Cocke County Hma, LLC | Past | Accepting new patients |
Locations
1225 E Weisgarber Rd
Ste 200
Knoxville, TN 37909
Phone (865) 938-3627
7211 Wellington Dr
Ste 101
Knoxville, TN 37919
Phone (865) 588-8005
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 15406 | TN | Yes |
Addresses
Primary practice location
434 4TH St Ste 305
Newport, TN 37821-3735
Mailing address
434 4TH St Ste 305
Newport, TN 37821-3735
Phone (865) 647-5800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q020197 | Medicaid | TN |
Other providers in Newport, TN
- Marpe Physio Wellness LLC
- Gina Marqua
- Heather Renea Marshall
- Lisa Mischelle Marshall
- Timothy Brenton Marsingill
- Kristin M Massey
- Mastering Minds, LLC
- Lawrence J Mathers
- Rachel A Mathers
- Jeffrey Allen Mathews
All providers in Newport, TN · Cardiovascular Disease Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.