Active NPI
Kathryn Brooke Martin, CCC-SLP
- Speech-Language Pathologist
- North Dinwiddie, VA
National Provider Identifier
1992139604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2202006651
- Practice address
- 46 Diamond Dr
North Dinwiddie, VA 23803-7495 - Phone
- (804) 518-0780
- Fax
- (804) 518-0787
- NPI assigned
- Aug 29, 2013
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 2202006651 | VA | Primary |
Addresses
Primary practice location
46 Diamond Dr
North Dinwiddie, VA 23803-7495
Mailing address
46 Diamond Dr
North Dinwiddie, VA 23803-7495
Phone (804) 518-0780
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519344000000",
"number": "1992139604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "46 DIAMOND DR",
"city": "NORTH DINWIDDIE",
"state": "VA",
"postal_code": "238037495",
"telephone_number": "804-518-0780",
"fax_number": "804-518-0787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "46 DIAMOND DR",
"city": "NORTH DINWIDDIE",
"state": "VA",
"postal_code": "238037495",
"telephone_number": "804-518-0780",
"fax_number": "804-518-0787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARTIN",
"first_name": "KATHRYN",
"middle_name": "BROOKE",
"credential": "CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-29",
"last_updated": "2018-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "VA",
"license": "2202006651",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Dinwiddie, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.