SHANE DOUGLAS MARTIN (NPI# 1386872588) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386872588 |
| Entity Type | Individual |
| Full Name | SHANE DOUGLAS MARTIN |
| Credential | DO |
| Practice Address |
4201 Campus Ridge Drive Midland MI 48640 |
| Practice Telephone | 9898391795 |
| Practice Fax Number | 9898391785 |
| Mailing Telephone | 9898391795 |
| Mailing Fax Number | 9898391785 |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2016-11-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 5101018126 | MI | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952815532 | Shane Martin | Registered Nurse | 2110 Augusta St, Eugene, OR 97403-2202 | 2017-11-19 |
| 1417439092 | Shane Douglas Martin | Counselor | 1333 Nw 9th St, Prineville, OR 97754-1482 | 2018-08-30 |
| 1235421090 | Shane Martin | Rehabilitation Practitioner | 100 Rosaschi Rd, Yerington, NV 89447-8722 | 2011-05-11 |
| 1588842843 | Shane M Martin | Pharmacist | 52d Medical Group, Unit 3865, Apo, AE 09126-3865 | 2008-02-07 |
| 1659351682 | Shane L Martin | Orthopaedic Surgery | 18700 N 64th Dr, Ste 105, Glendale, AZ 85308-7109 | 2006-01-17 |
| Street Address |
4201 CAMPUS RIDGE DRIVE |
| City | MIDLAND |
| State | MI |
| Zip Code | 48640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376541441 | Wilfred Lewis Vander Roest | Internal Medicine | 4201 Campus Ridge Drive, Midland, MI 48640 | 2005-07-12 |
| 1538511571 | Kathryn E Esch | Nurse Practitioner | 4201 Campus Ridge Drive, Midland, MI 48640 | 2016-07-01 |
| 1952793622 | Steven Laporte | Nurse Practitioner | 4201 Campus Ridge Drive, Midland, MI 48640 | 2015-03-04 |
| 1790177707 | Devon Brodie | Nurse Practitioner | 4201 Campus Ridge Drive, Midland, MI 48640 | 2015-02-27 |
| 1407259658 | Erik Kuhl | Physician Assistant | 4201 Campus Ridge Drive, Midland, MI 48640 | 2014-10-02 |
| 1689082406 | Ardeth Greene | Registered Nurse | 4201 Campus Ridge Drive, Midland, MI 48640 | 2014-07-24 |
| 1790196145 | Sharon Hakes | Nurse Practitioner | 4201 Campus Ridge Drive, Midland, MI 48640 | 2014-05-19 |
| 1487077301 | Jamie Trumble | Nurse Practitioner | 4201 Campus Ridge Drive, Midland, MI 48640 | 2014-01-29 |
| 1609217603 | Jennifer A Muzzy | Nurse Practitioner | 4201 Campus Ridge Drive, Midland, MI 48640 | 2013-07-08 |
| 1861775959 | Stephanie Marie Mallord | Nurse Practitioner | 4201 Campus Ridge Drive, Midland, MI 48640 | 2011-09-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407481260 | Sdpa Management Pllc | Dentist | 4915 Jefferson Ave., Midland, MI 48640 | 2020-03-11 |
| 1598237364 | Michelle Marie Arthur | Occupational Therapist | 3007 North Saginaw Rd, Midland, MI 48640 | 2018-12-18 |
| 1295202349 | Personal Assistance Options | Private Vehicle | 1509 Washington Street, Suite C, Midland, MI 48640 | 2018-10-26 |
| 1972094720 | Ashley E Cline | Technician, Other | 5405 Oakridge Dr., Midland, MI 48640 | 2018-05-27 |
| 1669963898 | Hope Richelle Walker | Social Worker | 396 S 9 Mile Rd, Midland, MI 48640 | 2018-05-23 |
| 1568964807 | David Isaac Bearss | Physical Therapist | 4401 Campus Ridge Drive, Suite 1000, Midland, MI 48640 | 2018-03-02 |
| 1295237741 | Ashley Michelle Ghose | Physical Therapist | 4401 Campus Ridge Drive Suite 1000, Midland, MI 48640 | 2018-03-01 |
| 1801306055 | Elizabeth Diana Dickerson | Social Worker | 218 Fast Lane Drive, Midland, MI 48640 | 2017-10-02 |
| 1528502275 | Sheila Jensen | Behavior Technician | 248 E Dopp Rd, Midland, MI 48640 | 2016-12-15 |
| 1518328657 | Becky Staudacher | Technician, Other | 707 Mill St, Midland, MI 48640 | 2016-03-17 |
| Find all providers in zip 48640 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659615789 | Dennis Robert Vandorp Jr. | Surgery | 4201 Campus Ridge Dr Ste 2000, Midland, MI 48640 | 2012-11-15 |
| 1497047708 | Guillermo E Brachetta Md Pa | Surgery | 2300 W Michigan Ave Ste 1, Midland, TX 79701-5855 | 2011-05-04 |
| 1588857874 | John William Mathewson | Surgery | 5615 Deauville Ste 220, Midland, TX 79706-2707 | 2007-08-21 |
| 1336282664 | Guillermo Eduardo Brachetta | Surgery | 2300 Michigan Ave, Suite #1, Midland, TX 79701 | 2007-02-15 |
| 1265572135 | Melwyn J Sequeira | Surgery | 4201 Campus Ridge, Midland, MI 48640 | 2007-02-08 |
| 1255429395 | Sriramamurthy Subbaraman | Surgery | 4214 Andrews Hwy Ste 208, Midland, TX 79703-4868 | 2006-10-11 |
| 1710942917 | Sandeepa Musunuru | Surgery | 2405 W Missouri Ave, Midland, TX 79701-6800 | 2006-04-19 |
| 1689662926 | Midland Surgical Group PC | Surgery | 4007 Orchard Dr, Suite 2003, Midland, MI 48640-6187 | 2005-10-11 |
| 1144839689 | Urgent Orthopedic Pa Affiliates, Pllc | Surgery | 4304 Andrews Hwy, Midland, TX 79703-4824 | 2020-07-30 |
| 1760741359 | Timothy Gutierrez | Surgery | 2405 W Missouri Ave, Midland, TX 79701-6800 | 2012-05-16 |
| Find all providers in MIDLAND | ||||
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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.