NICOLAS CLAY MARTIN (NPI# 1477668606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477668606 |
| Entity Type | Individual |
| Full Name | NICOLAS CLAY MARTIN |
| Credential | D.P.M. |
| Practice Address |
12639 Old Tesson Rd Ste 115 Saint Louis MO 63128 |
| Mailing Address |
12639 Old Tesson Rd Ste 115 Saint Louis MO 63128-2786 |
| Practice Telephone | 3148490311 |
| Practice Fax Number | 3148494423 |
| Mailing Telephone | 3148490311 |
| Mailing Fax Number | 3148494423 |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2019-07-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
2005025463 | MO | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | RAILROAD MEDICARE | P00457779 | 01 |
| MO | 304056609 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356845994 | Nicolas Martin | Physical Therapist | 29 Round Tree Dr, Palm Coast, FL 32164-6955 | 2018-03-20 |
| 1568012029 | Nicolas Martin | Physician Assistant | 1425 Portland Ave, Rochester, NY 14621-3011 | 2019-09-17 |
| Street Address |
12639 OLD TESSON RD STE 115 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447861836 | Sarah E Brinkmann | Nurse Practitioner | 12639 Old Tesson Rd Ste 115, Saint Louis, MO 63128-2786 | 2020-08-11 |
| 1477011914 | Katherine Rose Stecher | Physician Assistant | 12639 Old Tesson Rd Ste 115, Saint Louis, MO 63128-2786 | 2019-03-04 |
| 1326558164 | Aaron Michelle Perkins | Physician Assistant | 12639 Old Tesson Rd Ste 115, Saint Louis, MO 63128-2786 | 2017-10-06 |
| 1942756200 | Curtis Steinlage | Physician Assistant | 12639 Old Tesson Rd Ste 115, Saint Louis, MO 63128 | 2016-08-28 |
| 1982014767 | Sridhar Pinnamaneni | Orthopaedic Surgery | 12639 Old Tesson Rd Ste 115, Saint Louis, MO 63128-2786 | 2014-05-02 |
| 1952746521 | Kenneth Sanders Smith Jr. | Orthopaedic Surgery | 12639 Old Tesson Rd Ste 115, Saint Louis, MO 63128-2786 | 2013-05-08 |
| 1922340603 | Ashley Haegele Ali | Orthopaedic Surgery | 12639 Old Tesson Rd Ste 115, Saint Louis, MO 63128-2786 | 2013-03-20 |
| 1922362565 | Christopher Warner Palmer | Orthopaedic Surgery | 12639 Old Tesson Rd Ste 115, Saint Louis, MO 63128-2786 | 2012-06-28 |
| 1851435903 | Ellen G. Barton | Physician Assistant | 12639 Old Tesson Rd Ste 115, Saint Louis, MO 63128-2786 | 2007-02-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235771155 | James T Fetsch Dmd LLC | Dentist | 10004 Kennerly Rd Suite 240, Saint Louis, MO 63128 | 2019-10-11 |
| 1326504655 | Nikodem Dental Holdings | Dentist | 4337 Butler Hill Rd Suite G, St Louis Mo, MO 63128 | 2019-02-12 |
| 1932678505 | Michelle Anne Arvidson | Physical Therapy Assistant | Elite Physical Therapy, 12608 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2018-11-13 |
| 1245726710 | Kristen Rider | Nurse Practitioner | 9964 Kennerly Rd Ste D, Saint Louis, MO 63128 | 2018-07-07 |
| 1306217427 | Sophia Bednarski | Dentist | 12660 Lamplighter Square Shopping Center, St. Louis, MO 63128 | 2015-10-15 |
| 1427434224 | Darcie Burrus | Counselor | 12523 Old Tesson Rd G, St Louis, MO 63128 | 2015-08-04 |
| 1710368584 | Sara Hawatmeh | Internal Medicine | 12345 W Bend Dr Ste 304, Saint Louis, MO 63128 | 2015-06-17 |
| 1871989590 | Celia Grace Montes-kolence | Speech-Language Pathologist | 12335 W Bend Drive, Saint Louis, MO 63128 | 2015-04-09 |
| 1245629302 | Marius Antonio Evans | Dentist | 9911 Kennerly Rd., Suite G, St. Louis, MO 63128 | 2015-01-13 |
| 1801230313 | Sarah Elizabeth Walsh | Emergency Medicine | 10010 Kennerly Road, Emergency Department, St. Anthony's Medical Center, St. Louis, MO 63128 | 2013-04-26 |
| Find all providers in zip 63128 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851923023 | Center for Advanced Foot & Ankle Surgery, Inc. | Podiatrist | 3915 Watson Rd Ste 200, Saint Louis, MO 63109-1251 | 2020-02-06 |
| 1518486885 | Sunflower Podiatry and Wellness | Podiatrist | 1316 Hebert Street, Saint Louis, MO 63107 | 2017-09-18 |
| 1669745501 | West County Foot and Ankle LLC | Podiatrist | 10004 Kennerly Rd Ste 300a, Saint Louis, MO 63128 | 2012-02-22 |
| 1255620340 | Blackmun Footcare LLC | Podiatrist | 2608 N 14th St, Saint Louis, MO 63106-3913 | 2011-03-29 |
| 1053623058 | Camille Patrice Ryans | Podiatrist | 11056 Oak Spur Ct Apt K, Saint Louis, MO 63146-1973 | 2010-07-07 |
| 1437314812 | Raymond Angelo Brickhouse Jr. | Podiatrist | 3535 S Jefferson Ave Ste 201, Saint Louis, MO 63118-3922 | 2008-07-24 |
| 1114068988 | Dr. Veda E. Lewis-simmons Dpm Mha LLC | Podiatrist | 10421 W Florissant Ave, Saint Louis, MO 63136-2342 | 2007-02-12 |
| 1346389095 | Foot & Ankle Center, LLC | Podiatrist | 11066 Olive Blvd, Saint Louis, MO 63141-7615 | 2007-02-06 |
| 1548325533 | Mid-west Podiatry & Associates, LLC | Podiatrist | 2 Millstone Campus Dr, Saint Louis, MO 63146-5776 | 2006-12-27 |
| 1275589038 | Vincent J Staschiak | Podiatrist | 8637 Delmar Blvd, Saint Louis, MO 63124-1906 | 2006-05-25 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63128 |
Please comment or provide details below to improve the information on NICOLAS CLAY MARTIN.
| 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.