Individual provider Active NPI

John W Martin, PHARMD

  • Pharmacist
  • Dolgeville, NY
National Provider Identifier
1972825073
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
052592 Issued in NY
Practice address
55 N Main St
Dolgeville, NY 13329-1338
Phone
(315) 429-8565
NPI assigned
Feb 17, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 052592 NY Primary

Addresses

Primary practice location

55 N Main St
Dolgeville, NY 13329-1338

Mailing address

99 Bozenkill Rd
Altamont, NY 12009-6000
Phone (518) 258-8457

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
052592NYMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
KPH Healthcare Services, Inc. Past Accepting new patients
KPH Healthcare Services, Inc. PastSince May 9, 2021 Accepting new patients
KPH Healthcare Services, Inc. PastSince May 9, 2021 Accepting new patients

Organizations & group practices 3

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": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1972825073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 BOZENKILL RD",
            "city": "ALTAMONT",
            "state": "NY",
            "postal_code": "120096000",
            "telephone_number": "518-258-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 N MAIN ST",
            "city": "DOLGEVILLE",
            "state": "NY",
            "postal_code": "133291338",
            "telephone_number": "315-429-8565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "JOHN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-17",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "052592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dolgeville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.