Individual provider Active NPI

Robert M Martin, MS CFNP

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1922004159
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN7953 Issued in TN
Practice address
11541 Kingston Pike
Ste 101
Knoxville, TN 37934-0000
Phone
(865) 675-7522
Fax
(865) 671-3196
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN7953 TN Primary

Addresses

Primary practice location

11541 Kingston Pike
Ste 101
Knoxville, TN 37934-0000

Mailing address

11541 Kingston Pike
Ste 101
Knoxville, TN 37934-0000
Phone (865) 675-7522

Other identifiers 2

IdentifierTypeStateIssuer
3908484MedicaidTN
44D0993636OtherFED CLIA ID NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040809001122 TN Practitioner - Nurse Practitioner 9133191364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Tennessee, HSC, College of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11541 Kingston Pike
Suite 101
Knoxville, TN 37934-3918

11541 Kingston Pike
Suite a
Knoxville, TN 37934-3990
Phone (865) 675-7522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN7953TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Family Healthcare, PLLC CurrentSince May 1, 2001 Accepting new patients
Advantage Family Healthcare, PLLC Family CurrentSince Jan 1, 1990 Accepting new patients

Locations

11541 Kingston Pike
Ste 101
Knoxville, TN 37934
Phone (865) 675-7522

Organizations & group practices 2

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1922004159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11541 KINGSTON PIKE",
            "address_2": "STE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379340000",
            "telephone_number": "865-675-7522",
            "fax_number": "865-671-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11541 KINGSTON PIKE",
            "address_2": "STE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379340000",
            "telephone_number": "865-675-7522",
            "fax_number": "865-671-3196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "ROBERT",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "MS CFNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN7953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3908484",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED CLIA ID NUMBER",
            "identifier": "44D0993636",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.