Active NPI
Kelly Martin, BS, MS
- Nutrition Education Nutritionist
- Lusby, MD
National Provider Identifier
1962014530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Education Nutritionist
- Practice address
- 225 Town Square Dr
Lusby, MD 20657-6534 - Phone
- (610) 952-7881
- NPI assigned
- Aug 17, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | PA | Primary |
Addresses
Primary practice location
225 Town Square Dr
Lusby, MD 20657-6534
Mailing address
48346 Long LN
Lexington Park, MD 20653-4527
Phone (610) 952-7881
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor of Science, Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597622400000",
"number": "1962014530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48346 LONG LN",
"city": "LEXINGTON PARK",
"state": "MD",
"postal_code": "206534527",
"telephone_number": "610-952-7881"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 TOWN SQUARE DR",
"city": "LUSBY",
"state": "MD",
"postal_code": "206576534",
"telephone_number": "610-952-7881"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "KELLY",
"credential": "BS, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-17",
"last_updated": "2020-08-17",
"certification_date": "2020-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "PA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lusby, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.