TOM D MARTIN (NPI# 1801888276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801888276 |
| Entity Type | Individual |
| Full Name | TOM D MARTIN |
| Credential | MD |
| Practice Address |
1050 M L King Dr Suite 104 Centralia IL 62801-3060 |
| Practice Telephone | 6185326330 |
| Practice Fax Number | 6185327227 |
| Mailing Telephone | 6185326330 |
| Mailing Fax Number | 6185327227 |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2009-07-23 |
| NPI Deactivation Date | 03/25/2006 |
| NPI Reactivation Date | 2006-04-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 3640120 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036040120 | 05 | |
| IL | BLUECROSSBLUSSHIELD | 0006100071 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083875751 | Tom Pearce Martin | Clinic/Center | 10900 Porter Ln, Junction, IL 62954-2200 | 2008-06-24 |
| 1588707855 | Tom R Martin | Counselor | 1790 W 11th Avenue, Sheltercare, Eugene, OR 97402 | 2007-02-15 |
| Street Address |
1050 M L KING DR SUITE 104 |
| City | CENTRALIA |
| State | IL |
| Zip Code | 62801-3060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780681700 | Elizabeth Franczyk | Specialist | 1050 M L King Dr, Suite 102, Centralia, IL 62801-3060 | 2005-07-05 |
| 1699045740 | Dr Shrestha Md Sc | Clinic/Center | 1050 M L King Dr, Suite 111, Centralia, IL 62801-3060 | 2012-01-06 |
| 1114120177 | Kamran Amir Khan | Hospitalist | 1050 M L King Dr, Suite 109, Centralia, IL 62801-3060 | 2007-06-07 |
| 1790810216 | Naeem A Khan Md Sc | Internal Medicine | 1050 M L King Dr, Suite 108, Centralia, IL 62801-3060 | 2007-02-23 |
| 1275540015 | Aziz U Rahman | Internal Medicine | 1050 M L King Dr, Suite 109, Centralia, IL 62801-3060 | 2006-08-02 |
| 1245259274 | Rajendra R Shroff | Internal Medicine | 1050 M L King Dr, Suite 101, Centralia, IL 62801-3060 | 2006-07-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356996151 | Matthew Crawford | Counselor | 904 E Martin Luther King Dr, Centralia, IL 62801 | 2019-08-08 |
| 1588130314 | Kennah White | Counselor | 904 E. Mlk Drive, Centralia, IL 62801 | 2018-10-19 |
| 1245721588 | Lindsey Nicole Fogliasso | Counselor | 904 East Mlk Dr., Centralia, IL 62801 | 2018-05-22 |
| 1629573365 | Prabhat Shrestha | Student in an Organized Health Care Education/Training Program | 605 Sable Drive, Centralia, IL 62801 | 2018-03-26 |
| 1619496098 | Whitney Rathmann | Speech-Language Pathologist | 224 South Locust, Centralia, IL 62801 | 2017-09-17 |
| 1376082685 | Athena A Smith | Counselor | 904 E. Martin Luther King Dr, Centralia, IL 62801 | 2017-02-20 |
| 1447704069 | Meghan Branch | Counselor | 904 Martin Luther King Dr, Centralia, IL 62801 | 2016-08-11 |
| 1568820637 | Midland Area Agency On Aging | Case Management | 434 S Poplar Street, Centralia, IL 62801 | 2016-02-04 |
| 1104201714 | Keri Douglas | Nurse Practitioner | 1054 M. L. King Drive #125, Centrailia, IL 62801 | 2015-07-24 |
| 1215331509 | Melissa Dane | Counselor | 904 E Martin Luther King Dr., Centralia, IL 62801 | 2014-10-15 |
| Find all providers in zip 62801 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073810354 | Tom Martin Md Sc | Internal Medicine | 1050 Ml King Dr, Suite 104, Centralia, IL 62801-3060 | 2011-02-22 |
| 1518132489 | Gibran Hamid Mahmud | Internal Medicine | 1052 M L King Dr, Suite 2, Centralia, IL 62801-3002 | 2008-04-23 |
| 1831369735 | Rajendra R Shroff Md Sc | Internal Medicine | 1050 M L King Dr Ste 101, Centralia, IL 62801-3060 | 2008-03-06 |
| 1417090044 | Romil Wadhawan | Internal Medicine | 1010 S Scheuber Rd, Suite 3&4, Centralia, WA 98531-8892 | 2007-02-14 |
| 1689714511 | Habibur Rahman | Internal Medicine | 2857, 161 East, Box 1233, Centralia, IL 62801-9118 | 2007-02-08 |
| 1699792242 | Guito Wingfield | Internal Medicine | 1707 Cooks Hill Rd, Centralia, WA 98531-9071 | 2006-07-17 |
| 1265467930 | Jong-wook Ban | Internal Medicine | 1010 S Scheuber Rd Ste 3&4, Centralia, WA 98531-8892 | 2006-07-11 |
| 1942260427 | Hari P Pathi | Internal Medicine | 914 S. Scheuber Road, Pmg Sw Wa PCh Hospitalists, Centralia, WA 98531 | 2006-03-27 |
| 1649267196 | Loren D Cooper | Internal Medicine | 1800 Cooks Hill Rd, Suite B, Centralia, WA 98531-9072 | 2005-09-30 |
| 1851392229 | James Louis Schutzenhofer | Internal Medicine | 1050 Martin Luther King Drive, Centralia, IL 62801 | 2005-08-09 |
| Find all providers in CENTRALIA | ||||
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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.