Jessica Lynn Martin

Primary specialty

Personal Care AttendantTaxonomy code 3747P1801X

License

MAR815845 Issued in ND

Practice address

4200 39TH Avenue NW
Mandan, ND 58554

Phone

(701) 391-4602

NPI assigned

Nov 21, 2020

Last updated

Nov 21, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1605916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605916800000",
    "number": "1922601830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 39TH AVENUE NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "58554",
            "telephone_number": "701-391-4602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 39TH AVENUE NW",
            "city": "MANDAN",
            "state": "ND",
            "postal_code": "58554",
            "telephone_number": "701-391-4602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-21",
        "last_updated": "2020-11-21",
        "certification_date": "2020-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3747P1801X",
            "taxonomy_group": "",
            "desc": "Technician, Personal Care Attendant",
            "state": "ND",
            "license": "MAR815845",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Mandan",
            "affiliation": "N",
            "endpointDescription": "Home Office",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Mandan",
            "address_1": "4200 39th Avenue NW",
            "city": "Mandan",
            "state": "ND",
            "country_code": "US",
            "postal_code": "58554",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mandan Drug
• Mandan Public School District 1
• Krysten Manguson
• Kimberly Mark
• Julie Marmon
• Mariah Kae Martin
• Tracy D Martinson
• Tracey C Mathis
• Mary Matthews
• Kaimana Mauai

• Personal Care Attendant in Mandan, ND
• Providers in Mandan, ND by specialty
• Personal Care Attendant in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.