GERALD S MARTIN (NPI# 1770014748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770014748 |
| Entity Type | Individual |
| Full Name | GERALD S MARTIN |
| Credential | NP |
| Practice Address |
98 Peach Ridge Rd Anna IL 62906-2243 |
| Mailing Address |
Po Box 3988 Carbondale IL 62902-3988 |
| Practice Telephone | 6186141400 |
| Practice Fax Number | 6186141401 |
| Mailing Telephone | 6184575200 |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2020-11-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 209015754 | IL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | MEDICARE GROUP PTAN | 214881 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538423918 | Gerald Wesley Martin | Pharmacist | 453 Wildwood Dr, Grand Junction, CO 81507-2505 | 2012-06-29 |
| 1881685725 | Gerald Thomas Martin | Dentist | 2012 N Main St, Shelbyville, TN 37160-2022 | 2005-10-31 |
| 1194713511 | Gerald B Martin | Internal Medicine | 64 S West St, Carlisle, PA 17013 | 2005-10-10 |
| 1871736215 | Gerald Jerome Martin | Student in an Organized Health Care Education/Training Program | 445 Ledyard St, Detroit, MI 48201-2641 | 2009-04-15 |
| 1871670869 | Gerald E Martin Jr. | Chiropractor | 840 W University Dr, Suite # 7, Mesa, AZ 85201-5529 | 2006-11-01 |
| 1760570840 | Gerald Mikel Martin | Family Medicine | 350 S 40th St, Muskogee, OK 74401-4915 | 2006-10-11 |
| 1194784009 | Gerald R Martin | Internal Medicine | 317 Chestnut St, Brevard, NC 28712-3898 | 2006-03-20 |
| Street Address |
98 PEACH RIDGE RD |
| City | ANNA |
| State | IL |
| Zip Code | 62906-2243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538689062 | Southern Illinois Medical Services, Nfp | Clinic/Center | 98 Peach Ridge Rd, Anna, IL 62906-2243 | 2017-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265711600 | Community Integrated Living, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 110 Jeni Lane, Anna, IL 62906 | 2011-08-16 |
| 1508153768 | Union County Counseling Services Inc | Clinic/Center | 202 South St, Anna, IL 62906 | 2011-07-07 |
| 1326335589 | Union County Counseling Services Inc | Clinic/Center | 302 South St, Anna, IL 62906 | 2011-07-07 |
| 1063709228 | Union County Counseling Services Inc | Community Based Residential Treatment Facility, Mental Illness | 311 W Vienna St, Anna, IL 62906 | 2011-07-07 |
| 1598920928 | Steven Wayne Vincent | Dentist | 131 West Vienna Street, Anna, IL 62906 | 2008-07-24 |
| 1427236900 | Cardinal House Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 200 Douglas Street, Anna, IL 62906 | 2008-02-06 |
| 1992913719 | High Chiropractic Center | Chiropractor | 35 Walton Lane, Anna, IL 62906 | 2007-05-18 |
| 1023235678 | Chuck C. Bugle | Psychologist | 311 W. Spring St., Anna, IL 62906 | 2007-04-18 |
| 1922194604 | Nancy Kay Webb | Physical Therapist | 515 E Vienna Street, Suite I, Anna, IL 62906 | 2006-10-04 |
| 1144242918 | William W Mings | Psychiatry & Neurology | 204 South St, Anna, IL 62906 | 2006-07-24 |
| Find all providers in zip 62906 | ||||
| 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 |
|---|---|---|---|---|
| 1245634948 | Jessica Elizabeth Wills | Nurse Practitioner | 513 N Main St, Anna, IL 62906-1668 | 2014-10-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578523 | Kaitlin Lawson Kalnitz | Nurse Practitioner | 745 Mcclintock Dr Ste 360, Burr Ridge, IL 60527-0875 | 2020-11-06 |
| 1841890290 | Maria Malanych | Nurse Practitioner | 5731 Rosinweed Ln, Naperville, IL 60564-1635 | 2020-10-27 |
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1295334811 | Mary Farley | Nurse Practitioner | 7308 Northwood Dr, Wonder Lake, IL 60097-8606 | 2020-10-24 |
| 1164021168 | Stephanie Schuster | Nurse Practitioner | 2665 Prairieview Ln N, Aurora, IL 60502-6343 | 2020-10-21 |
| 1316546641 | Vanessa K Bajaj | Nurse Practitioner | 1123 N Claremont Dr, Palatine, IL 60074-4002 | 2020-10-19 |
| 1003414442 | Gachugu Medical Clinic | Nurse Practitioner | 1 E Ferguson Ave, Wood River, IL 62095-1903 | 2020-10-16 |
| 1477151272 | Yolanda K Bradford | Nurse Practitioner | 2700 S California Ave, Chicago, IL 60608-5108 | 2020-10-14 |
| 1265030019 | Andrea Mclean | Nurse Practitioner | 2500 W Reynolds St # 205, Pontiac, IL 61764-9774 | 2020-10-14 |
| 1558968628 | Timothy Nenoff | Nurse Practitioner | 24722 Lincolnway St, Plainfield, IL 60544-2412 | 2020-10-02 |
| Find all providers with the same taxonomy | ||||
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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.