Individual provider Active NPI

Erin Martin, RD/LD

  • Registered Dietitian
  • Oklahoma City, OK
National Provider Identifier
1902177660
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1674 Issued in OK
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

Updated by the provider on Feb 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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 IDStateProvider typePAC IDDetails
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

LicenseStateTypeSpecialty
1674OKMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Life Nutrition Dietitian, Registered CurrentSince Jul 21, 2024 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.

Verify at the official NPI Registry.