Shane Martin, RN

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

201810779RN Issued in OR

Practice address

2110 Augusta St
Eugene, OR 97403-2202

Phone

(405) 630-5159

NPI assigned

Nov 19, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Shane Martin Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1511049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562284800000",
    "number": "1952815532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2110 AUGUSTA ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974032202",
            "telephone_number": "405-630-5159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2110 AUGUSTA ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974032202",
            "telephone_number": "405-630-5159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2617 General Pershing Blvd",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731076437",
            "country_code": "US",
            "telephone_number": "405-858-1700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "SHANE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-11-19",
        "last_updated": "2019-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OK",
            "license": "116346",
            "primary": false
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201810779RN",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANE",
            "last_name": "MARTIN",
            "credential": "RN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Maria Renee Martin, LTA, LE
• Michael Jack Martin, MA MFTI
• Orion Guinn Martin, MSP
• Pauline G Martin, LCSW
• Sarah Ann Martin, LMFT
• Sharon A Martin, QMHP
• Spencer Allan Martin, MASSAGE THERAPIST
• Summer Martin
• Teara Martin
• Tom R Martin, BS

• Psychiatric/Mental Health Registered Nurse in Eugene, OR
• Providers in Eugene, OR by specialty
• Psychiatric/Mental Health Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; 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.