Dianne Martin MD Professional Corporation

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

01029502A Issued in IN

Legal business name

DIANNE MARTIN MD PROFESSIONAL CORPORATION

Practice address

5670 Caito Dr
Suite # 125 Building #5
Indpls, IN 46226-1364

Phone

(317) 541-9159

Fax

(317) 541-9179

NPI assigned

Jan 27, 2009

Last updated

May 13, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Dianne Martin, MDNPI 1215030366

Title

MD/Psychiatrist

Phone

(317) 541-9154

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Dianne Martin MD PC Former legal business name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dianne Martin, MD

  • Psychiatry Physician
  • Indpls, IN
  • NPI 1215030366
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399939200000",
    "number": "1891933032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5670 CAITO DR",
            "address_2": "SUITE # 125 BUILDING #5",
            "city": "INDPLS",
            "state": "IN",
            "postal_code": "462261364",
            "telephone_number": "317-541-9159",
            "fax_number": "317-541-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5670 CAITO DR",
            "address_2": "SUITE # 125 BUILDING #5",
            "city": "INDPLS",
            "state": "IN",
            "postal_code": "462261364",
            "telephone_number": "317-541-9159",
            "fax_number": "317-541-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANNE MARTIN MD PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-27",
        "last_updated": "2014-05-13",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_title_or_position": "MD/PSYCHIATRIST",
        "authorized_official_telephone_number": "317-541-9154",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01029502A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100235680",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200930000A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dianne Martin MD PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• David Wayne Christenson
• Chrissa L Collings, MD
• Community Gastroenterology PC
• Juliane Cunningham
• Laurie A Dawley, CFNP/ANP
• Tara Elsner, LCSW
• Cletis R Foster, DDS
• Tejuana Garnes, LICENSED CLINICAL SO
• Abbie Ann Grudzien
• Deidre East Guerrettaz, DDS

• Psychiatry Physician in Indpls, IN
• Providers in Indpls, IN by specialty
• Psychiatry Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.