Active NPI
Erin Martin, RD/LD
- Registered Dietitian
- Oklahoma City, OK
National Provider Identifier
1902177660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1674
- Practice address
- 4334 NW Expressway Ste 163
Suite 163
Oklahoma City, OK 73116-1515 - Phone
- (405) 942-4308
- Fax
- (405) 942-6011
- NPI assigned
- Jan 25, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 1674 | OK | Primary |
Addresses
Primary practice location
4334 NW Expressway Ste 163
Suite 163
Oklahoma City, OK 73116-1515
Mailing address
4334 NW Expressway Ste 163
Suite 163
Oklahoma City, OK 73116-1515
Phone (405) 942-4308
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OK
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120816000695 | OK | Practitioner - Registered Dietitian Or Nutrition Professional | 0446406847 | Practice locations: Oklahoma City, OK |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1674 | OK | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Nutrition | Dietitian, Registered | Current | Accepting new patients |
Locations
4334 NW Expressway
Ste 163
Oklahoma City, OK 73116
Phone (405) 942-4308
Organizations & group practices 1
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": "1327449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487116800000",
"number": "1902177660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4334 NW EXPRESSWAY STE 163",
"address_2": "SUITE 163",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731161515",
"telephone_number": "405-942-4308",
"fax_number": "405-942-6011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4334 NW EXPRESSWAY STE 163",
"address_2": "SUITE 163",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731161515",
"telephone_number": "405-942-4308",
"fax_number": "405-942-6011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "ERIN",
"name_prefix": "Mrs.",
"credential": "RD/LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-01-25",
"last_updated": "2017-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "OK",
"license": "1674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oklahoma City, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.