MISS KIMBERLY CHARISE MARTIN (NPI# 1063946358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063946358 |
| Entity Type | Individual |
| Full Name | MISS KIMBERLY CHARISE MARTIN |
| Credential | NP-C |
| Practice Address |
1802 Braeburn Dr Salem VA 24153-7357 |
| Mailing Address |
2000 Health Park Dr Fl Hp2 Brentwood TN 37027-4525 |
| Practice Telephone | 5407723400 |
| Mailing Telephone | 6153737600 |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2019-01-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 0024174765 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
0024174765 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770190282 | Kimberly F Martin | Technician | 370 Nunner Rd, Maineville, OH 45039-8515 | 2020-09-29 |
| 1801412390 | Kimberly Alberta Martin | Counselor | 2368 Crescent St Fl 1, Astoria, NY 11105-3108 | 2020-06-19 |
| 1174161756 | Kimberly Lynn Martin | Case Manager/Care Coordinator | 141 Twin Lake Ln, Princeton, WV 24739-9591 | 2019-12-14 |
| 1316418361 | Kimberly Cathleen Martin | Nurse Practitioner | 607 Old Highway 24 W, Kokomo, MS 39643-5052 | 2018-12-16 |
| 1114494424 | Kimberly Martin | Rehabilitation Practitioner | 6655 S Fort Apache Rd Unit 110, Las Vegas, NV 89148-5061 | 2018-10-25 |
| 1700333416 | Kimberly Martin | Behavioral Analyst | 7421 Nw 34th St, Lauderhill, FL 33319-7103 | 2016-09-10 |
| 1467730838 | Kimberly Ann Martin | Speech-Language Pathologist | 7350 Hawk Rd, Flower Mound, TX 75022-6266 | 2011-08-02 |
| 1154617413 | Kimberly M Martin | Registered Nurse | 1204 Drill Ave Ne, Palm Bay, FL 32907-1121 | 2011-06-24 |
| 1598050742 | Kimberly Martin | Physical Therapist | 2821 Kings Mill Rd, Greensboro, NC 27407-6431 | 2011-06-16 |
| 1487812764 | Kimberly Ann Martin | Occupational Therapist | 128 Northgate Dr, De Queen, AR 71832-1700 | 2008-05-23 |
| Street Address |
1802 BRAEBURN DR |
| City | SALEM |
| State | VA |
| Zip Code | 24153-7357 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134121338 | Mark R Hanabury Jr. | Specialist | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2005-06-01 |
| 1841851433 | Grace Julia Valiulis | Physician Assistant | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2019-06-24 |
| 1083279376 | Olivia Jayne Darwin | Physician Assistant | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2019-05-02 |
| 1487166088 | Christopher Cutchin Coulter | Nurse Practitioner | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2017-11-04 |
| 1699215434 | Shannon Michelle Snyder | Physician Assistant | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2017-02-27 |
| 1255875589 | Sarah Markwood | Nurse Practitioner | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2016-12-06 |
| 1437506789 | Nicole Crowder | Registered Nurse | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2016-05-17 |
| 1508228669 | Mohammed Abdul Khadar Siddiqui | Pediatrics | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2016-03-28 |
| 1851757629 | Alisha O Lipes | Physician Assistant | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2016-01-11 |
| 1043685399 | Megan Smith | Nurse Practitioner | 1802 Braeburn Dr, Salem, VA 24153-7357 | 2015-12-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669001228 | Paul Mcguire | Student in an Organized Health Care Education/Training Program | 1906 Braeburn Drive Psychiatry Gme, Salem, VA 24153 | 2020-04-06 |
| 1386114965 | Dynamic Medical LLC | Clinical Medical Laboratory | 1201 Texas Street, Salem, VA 24153 | 2018-11-27 |
| 1134607898 | Renew Psychiatry Services | Psychiatry & Neurology | 177 Electric Rd, Salem, VA 24153 | 2018-08-03 |
| 1508304015 | Samantha Getz | Assisted Living Facility | 3706 Knollridge Rd., Salem, VA 24153 | 2017-02-03 |
| 1518409762 | Melissa Ward | Case Manager/Care Coordinator | 1380 Southside Dr, Suite 100, Salem, VA 24153 | 2016-11-04 |
| 1154729051 | Allison Marie Parry | Physician Assistant | 1336 W Main St., Salem, VA 24153 | 2014-12-09 |
| 1598199457 | Stacy Stanley | Occupational Therapy Assistant | 4812 Moore Rd, Salem, VA 24153 | 2013-08-28 |
| 1366888034 | Dolores Hager | Speech-Language Pathologist | 1851 Harrogate Dr, Salem, VA 24153 | 2013-05-21 |
| 1073850764 | Joel Aaron Nickerson | Specialist/Technologist | 400 Spartan Dr., Salem High School, Salem, VA 24153 | 2013-01-15 |
| 1023387271 | National Diabetic Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 2153 Apperson Drive, Salem, VA 24153 | 2011-12-16 |
| Find all providers in zip 24153 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134759012 | Caleb James Calder | Nurse Practitioner | 11 Oakland St, Salem, MA 01970-1520 | 2020-01-20 |
| 1467928184 | Jean David Thomas | Nurse Practitioner | Salem Family Health Center, 47 Congress Street, Salem, MA 01970 | 2018-10-20 |
| 1407371388 | Debra Lee Jenkins | Nurse Practitioner | 1905 Mcvitty Rd, Salem, VA 24153-7405 | 2017-08-11 |
| 1003282310 | Rachell Renee Davis | Nurse Practitioner | 1793 13th St. Se, Salem, OR 97302 | 2015-08-20 |
| 1194108365 | Danielle Marlene Dupuis | Nurse Practitioner | 810 Commercial St Se, Salem, OR 97302 | 2015-07-06 |
| 1306272471 | Josh Hooton | Nurse Practitioner | 251 W State Road 198 Ste 3, Salem, UT 84653-5608 | 2013-09-20 |
| 1104082197 | Richard Fredrick Meyers | Nurse Practitioner | 670 Hawthorne Ave Se, Suite 160, Salem, OR 97301-6884 | 2008-07-30 |
| 1831398122 | Karlen E Luthy | Nurse Practitioner | 118 N Main St Ste B, Salem, UT 84653-5698 | 2007-07-16 |
| 1174603401 | Anthony G Haralabatos | Nurse Practitioner | 59 Stiles Rd 104, Salem, NH 03079-5816 | 2006-10-17 |
| 1457378044 | Robert M Wilkinson | Nurse Practitioner | 141 Hospital Dr Ste 103, Salem, KY 42078-8043 | 2006-07-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.