Kyndall Grace Martin, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

E17999 Issued in AR

Practice address

2601 Gene George Blvd
Springdale, AR 72762-0845

Phone

(479) 309-5391

NPI assigned

Apr 5, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pediatric Medicine

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1036.epichosted.com/APIProxyPRD/AC/api/FHIR/R4

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.

• Arkansas Childrens Professional Services Organization LLC

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1629889464
  Medicare reassignment NPD
• Arkansas Children'S Medical Group PLLC

  • Pediatrics Physician
  • Little Rock, AR
  • NPI 1396274841
  NPD (past)
• Arkansas Childrens Northwest, Inc.

  • Children's Hospital
  • Springdale, AR
  • NPI 1255875746
  NPD (past)

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1902485360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 GENE GEORGE BLVD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620845",
            "telephone_number": "479-309-5391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 GENE GEORGE BLVD",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727620845",
            "telephone_number": "479-309-5391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Childrens Way # 512-19A",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722023500",
            "country_code": "US",
            "telephone_number": "501-364-1874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "KYNDALL",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-05",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AR",
            "license": "E17999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew Arthur Martin, MD
• Connie Ann Martin, LPC LMFT
• Fredrick Allan Martin, M.D.
• Heron B Martin, APRN
• Jennie P Martin, LAC
• Matthew Martin
• Sara Vanessa Martin
• Heather Ann Martinelli, MD
• Alyah Martinez
• Vanessa Martinez

• Pediatrics Physician in Springdale, AR
• Providers in Springdale, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.