DR. KURT MARTIN (NPI# 1164535365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164535365 |
| Entity Type | Individual |
| Full Name | DR. KURT MARTIN |
| Credential | M.D. |
| Practice Address |
2601 W Main St Carbondale IL 62901-1031 |
| Mailing Address |
Po Box 3988 Carbondale IL 62902-3988 |
| Practice Telephone | 6185495361 |
| Practice Fax Number | 6183514878 |
| Mailing Telephone | 6184575200 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 036-093490 | IL | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | 036-093490 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | HEALTHLINK INS NUMBER | 279844 | 01 |
| IL | RR MEDICARE NUMBER | 370012538 | 01 |
| IL | GHP | 324139 | 01 |
| IL | AETNA | 7210895 | 01 |
| IL | BCBS OF IL | 3932056 | 01 |
| IL | GHP INS. NUMBER | 49676 | 01 |
| IL | HAMP INSURANCE LNUMBER | 027530 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306825476 | Kurt F. Martin | Dentist | 2901 Canterbury Dr, Hays, KS 67601-2152 | 2006-01-17 |
| 1639174121 | Kurt R Martin | Orthopaedic Surgery | 1550 E County Line Rd, Ste 200, Indianapolis, IN 46227-0990 | 2005-06-20 |
| 1285981886 | Kurt Andersen Martin | Chiropractor | 206 W Nolana Ave, Mcallen, TX 78504-2513 | 2012-08-14 |
| Street Address |
2601 W MAIN ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548261399 | Jeffrey M Lehman | Allergy & Immunology | 2601 W Main St, Carbondale, IL 62901-1031 | 2005-08-02 |
| 1043846421 | Lindsay B Casolari | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2020-03-18 |
| 1194367318 | Jessica Oakley | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-10-09 |
| 1609424399 | Alexis Korbar | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-08-27 |
| 1184196883 | Leslie Ann Hickman | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-12-19 |
| 1679041685 | Kirsten Anne Beyers | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-11-07 |
| 1457834178 | Brittany Elizabeth Pierce | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-09-09 |
| 1306322110 | Katharine Johnson | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-07-15 |
| 1437699147 | Gina Gladson | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2017-02-28 |
| 1902349863 | Sarah Elizabeth Ruth Shannon | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901 | 2016-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285282137 | Castle Valley Children's Clinic | Pediatrics | 2615 Dolores Way Unit 103, Carbondale, CO 81623-2238 | 2019-09-03 |
| 1023582038 | Pediatric Group LLC | Pediatrics | 900 E Walnut St Ste 6, Carbondale, IL 62901-3132 | 2019-01-14 |
| 1336416619 | Wayne Memorial Community Health Centers | Pediatrics | 152 Brooklyn St, Carbondale, PA 18407-2208 | 2011-11-30 |
| 1356586119 | Geisinger Clinic | Pediatrics | 42 North Scott St, Carbondale, PA 18407-0000 | 2008-12-09 |
| 1518009414 | Maxis Medical Services | Pediatrics | 42 N Scott St, Carbondale, PA 18407-1888 | 2007-02-14 |
| 1871517466 | Paul F Ploegman | Pediatrics | 1111 Cedar Ct, Carbondale, IL 62901-5333 | 2006-07-27 |
| 1669445755 | Alexander J Pinsky | Pediatrics | 141 Salem Ave Ste 302, Carbondale, PA 18407-2500 | 2006-02-09 |
| 1255738597 | Amit Sharma | Pediatrics | 405 W Jackson St, Carbondale, IL 62901-1462 | 2014-12-02 |
| 1710225263 | Tomas Ignacio Munoz | Pediatrics | 405 W Jackson St, Carbondale, IL 62901-1462 | 2013-01-17 |
| 1467711796 | Lukasz Dabrowski | Pediatrics | 2601 W Main St, Carbondale, IL 62901-1031 | 2012-05-07 |
| Find all providers in CARBONDALE | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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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.