Individual provider Active NPI

Patrick Martin

  • Pharmacist
  • Cleveland, OH
National Provider Identifier
1972129849
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
03237064 Issued in OH
Practice address
16803 Lorain Ave
Cleveland, OH 44111-5510
Phone
(216) 252-3102
NPI assigned
Jun 17, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 03237064 OH Primary

Addresses

Primary practice location

16803 Lorain Ave
Cleveland, OH 44111-5510

Mailing address

1512 Wyandotte Ave
Lakewood, OH 44107-4726

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

State licenses

LicenseStateTypeSpecialty
03237064OHMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1972129849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 WYANDOTTE AVE",
            "city": "LAKEWOOD",
            "state": "OH",
            "postal_code": "441074726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16803 LORAIN AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441115510",
            "telephone_number": "216-252-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "PATRICK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03237064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

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

Verify at the official NPI Registry.