DR. NICHOLAUS BRUCE MARTIN (NPI# 1629053236) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629053236 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAUS BRUCE MARTIN |
| Credential | MD |
| Practice Address |
120 W Fine Ave Flagstaff AZ 86001-3016 |
| Practice Telephone | 9287739695 |
| Practice Fax Number | 9287730208 |
| Mailing Telephone | 9287739695 |
| Mailing Fax Number | 9287730208 |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2010-01-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208D00000X | General Practice | 40573 | CO | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 18430 | AZ | Allopathic & Osteopathic Physicians |
| Street Address |
120 W FINE AVE |
| City | FLAGSTAFF |
| State | AZ |
| Zip Code | 86001-3016 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114160363 | Sandra Glick-ridley | Physical Therapist | 120 W Fine Ave, Flagstaff, AZ 86001-3016 | 2009-04-16 |
| 1518082429 | Gil A Uy | Preventive Medicine | 120 W Fine Ave, Flagstaff, AZ 86001 | 2007-03-20 |
| 1386656791 | Occupational Health Center | Clinic/Center | 120 W Fine Ave, Flagstaff, AZ 86001-3016 | 2006-08-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658756 | Marlenne Adair Escobar-mendoza | Specialist/Technologist | 1705 South San Francisco Street, Flagstaff, AZ 86001 | 2020-10-27 |
| 1962033712 | Laura-lee Prescott | Social Worker | Northern Az Va Healthcare System, Flagstaff Cboc, 1300 W. University Ave., Suite 300, Flagstaff, AZ 86001 | 2020-01-30 |
| 1194360784 | Trinity Medical Consultants Pllc | Internal Medicine | 1521 N Cliff Drive, Flagstaff, AZ 86001 | 2019-11-07 |
| 1154849610 | Altacare, LLC | Family Medicine | 2700 S Woodlands Village Blvd Ste 700, Flagstaff, AZ 86001 | 2017-09-05 |
| 1487174926 | Lindsey Marie Forstie | Nurse Practitioner | 7263 E Dreamview Trail, Flagstaff, AZ 86001 | 2017-06-26 |
| 1255860763 | Welbrook Senior Living Flagstaff LLC | Skilled Nursing Facility | 1521 N Pine Cliff Dr, Flagstaff, AZ 86001 | 2017-06-08 |
| 1912432675 | Ryan Tiscareno | Specialist/Technologist | 621 West Cherry Ave, Flagstaff, AZ 86001 | 2017-05-01 |
| 1629432380 | Behavioral Consultation Services, Inc. | Clinic/Center | 345 S. River Run Road, Suite 200, Flagstaff, AZ 86001 | 2016-04-08 |
| 1275920928 | Junli Gallagher | Speech-Language Pathologist | 1215 N. Beaver St, Flagstaff, AZ 86001 | 2015-04-21 |
| 1932592599 | Kristen Flugstad Psyd, LLC | Psychologist | 125 East Elm Avenue #203, Flagstaff, AZ 86001 | 2015-03-06 |
| Find all providers in zip 86001 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003811068 | Christine Crowder | General Practice | 1501 S Yale St, Bldg 2 Suite 150, Flagstaff, AZ 86001-7304 | 2005-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475714 | Tri-medical Family Care, LLC | General Practice | 855 E Warner Rd Ste 100, Chandler, AZ 85225-0998 | 2020-10-20 |
| 1699374702 | Valley Spinal Care Pain Relief, LLC | General Practice | 15425 N Greenway Hayden Loop Ste A200, Scottsdale, AZ 85260-1239 | 2020-10-20 |
| 1225645625 | Olympus Health Management LLC | General Practice | 3813 E Oasis Cir, Mesa, AZ 85215-9796 | 2020-09-29 |
| 1952917205 | Physical Medicine of Mesa LLC | General Practice | 3614 E Southern Ave Ste 105, Mesa, AZ 85206-2510 | 2020-09-22 |
| 1346867488 | Infinity Pain Relief, LLC | General Practice | 8715 W Union Hills Dr Ste 109, Peoria, AZ 85382-3031 | 2020-07-05 |
| 1417570664 | Compass Medical Center Heber, Pllc | General Practice | 2931 Highway 260, Overgaard, AZ 85933 | 2020-05-22 |
| 1700408689 | Cottonwood Physician Group | General Practice | 1760 E Villa Dr Ste E&f, Cottonwood, AZ 86326-4679 | 2020-05-13 |
| 1457973406 | Pima County Physician Group | General Practice | 5155 E Farness Dr Ste 111b, Tucson, AZ 85712-2158 | 2020-05-13 |
| 1124649637 | Peoria Physician Group | General Practice | 13760 N 93rd Ave Ste 105, Peoria, AZ 85381-4260 | 2020-05-06 |
| 1366080475 | Madison Taylor Phillips | General Practice | 15741 Bering St, Ehrenberg, AZ 85334-0010 | 2019-12-19 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. NICHOLAUS BRUCE 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.