TINA MARTIN (NPI# 1902812324) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902812324 |
| Entity Type | Individual |
| Full Name | TINA MARTIN |
| Credential | N.P. |
| Practice Address |
2500 North State Street Jackson MS 39216 |
| Mailing Address |
Po Box 4528 Jackson MS 39296-4528 |
| Practice Telephone | 6019845500 |
| Practice Fax Number | 6019845499 |
| Mailing Telephone | 6019845500 |
| Mailing Fax Number | 6019845499 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-07-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 325064-22 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00122593 | 05 | |
| MS | MEDICARE ST DOM | 358766YKHV | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 969 Lakeland Dr, Jackson, MS 392164606 | 6012003631 | 6012000166 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235639048 | Tina Martin | Licensed Practical Nurse | 7668 Fm 2022, Grapeland, TX 75844-4348 | 2018-02-19 |
| 1033597208 | Tina Martin | Pharmacy Technician | 36361 Cinzia Ln, Winchester, CA 92596-8535 | 2015-05-08 |
| 1235298282 | Tina Garrard Martin | Occupational Therapist | 101 Bay Colony Elementary Dr, Dickinson, TX 77539-3950 | 2006-12-06 |
| 1952494619 | Tina Langeraap Martin | Physician Assistant | 1312 E Tonopah Ave, North Las Vegas, NV 89030-7111 | 2006-10-02 |
| 1992157283 | Tina Martin | Counselor | 206 W 5th St, Metropolis, IL 62960-1810 | 2016-07-11 |
| 1699180828 | Tina M Martin | Nurse's Aide | 22 North St, Jaffrey, NH 03452-5340 | 2014-06-26 |
| 1962771931 | Tina Myree Martin | Developmental Therapist | 2708 Ne 14th St Apt 5, Pompano Beach, FL 33062-3564 | 2011-12-21 |
| 1073647111 | Tina R Martin | Counselor | 1121 Detroit Ave, Concord, CA 94520-3113 | 2007-03-14 |
| 1821189689 | Tina C. Martin | Optometrist | 914 Fort Union Blvd, Midvale, UT 84047-1714 | 2006-09-27 |
| 1295798445 | Tina Ann Martin | Internal Medicine | 407 W 66th St, Richfield, MN 55423-2374 | 2006-04-10 |
| Street Address |
2500 NORTH STATE STREET |
| City | JACKSON |
| State | MS |
| Zip Code | 39216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376549816 | John Joseph Sheehan Jr. | Internal Medicine | 2500 North State Street, Department of Medicine Division of Digestive Disease, Jackson, MS 39216-4500 | 2005-06-21 |
| 1912520370 | Janna Leigh Williams | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Dept of Emergency Medicine, Jackson, MS 39216 | 2020-05-20 |
| 1609498401 | Chin-qune Oliver Yeung Lai Wah | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Jackson, MS 39216 | 2020-05-14 |
| 1689293250 | Karine Desouza | Family Medicine | 2500 North State Street, Attn: Department of Family Medicine, Jackson, MS 39216 | 2020-04-13 |
| 1225667249 | Mallory Browning | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Jackson, MS 39216-4505 | 2020-04-02 |
| 1912490400 | Alberto Andres Arteaga | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Ummc, Department of Otolaryngology - 5 East, Jackson, MS 39216 | 2018-06-11 |
| 1003309493 | Britton Postlethwaite Beatrous | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Ummc Ent Department - 5east, Jackson, MS 39216 | 2018-06-11 |
| 1750874145 | Joseph Alexander De Gruy | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Ummc Ent Department - 5east, Jackson, MS 39216 | 2018-06-11 |
| 1689161523 | Joshua Phillip Rouhan | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Department of Emergency Medicine, Jackson, MS 39216-4505 | 2018-04-17 |
| 1336660356 | Iram Aman | Student in an Organized Health Care Education/Training Program | 2500 North State Street, Jackson, MS 39216 | 2017-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861011553 | Ashley Melancon Prewitt | Registered Nurse | St. Dominic's North Campus, Behavioral Health, Jackson, MS 39216 | 2020-04-13 |
| 1194353391 | Brianna Arrington | Student in an Organized Health Care Education/Training Program | Med/ Peds, 2500 N. State St., Jackson, MS 39216 | 2020-04-01 |
| 1720616485 | Roshina Khalid Khan | Student in an Organized Health Care Education/Training Program | Department of Anesthesiology, Ummc, 2500 N. State St., Jackson, MS 39216 | 2020-03-30 |
| 1275183550 | Amanda Lynn Morellato | Dentist | Ummc School of Dentistry, 2500 North State Street, Jackson, MS 39216 | 2019-09-18 |
| 1396305553 | Abhishek Chhabra | Student in an Organized Health Care Education/Training Program | Lakeland Family Medicine Clinic, 878 Lakeland Dr., Jackson, MS 39216 | 2019-06-19 |
| 1427615996 | Hometown Diagnostics | Clinical Medical Laboratory | Translational Research Center Tr311, 2500 North State Street, Jackson, MS 39216 | 2019-05-21 |
| 1346807773 | Shukundala C Smith | Behavior Technician | New Learning Resources 2510 Lakeland Terrace, Jackson, MS 39216 | 2019-05-21 |
| 1063901098 | G Eli Howell Md Pllc | Plastic Surgery | 971 Lakeland Dr Ste 225, Jackson, MS 39216 | 2018-05-04 |
| 1588168132 | Caleb Zumbro | Student in an Organized Health Care Education/Training Program | Ummc Med/peds, 2500 N. State St., Jackson, MS 39216 | 2018-03-20 |
| 1639677230 | Walgreen Co | Pharmacy | 971 Lakeland Dr Ste 101, Jackson, MS 39216 | 2018-01-29 |
| Find all providers in zip 39216 | ||||
| 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 |
|---|---|---|---|---|
| 1093332546 | Jaleesa Atkins | Nurse Practitioner | 4266 Springbrook Rd, Jackson, MI 49201-9716 | 2020-07-01 |
| 1457983785 | Amos N Macharia | Nurse Practitioner | 2130 Ridge Rd, Jackson, MO 63755-1612 | 2020-02-05 |
| 1649819590 | George Cavett Jr. | Nurse Practitioner | 2450 Twisted Oak Dr, Jackson, MS 39212-2137 | 2019-12-24 |
| 1851934723 | Hannah Louise Keel | Nurse Practitioner | 623 Gettysburg Dr, Jackson, TN 38305-7886 | 2019-10-23 |
| 1013559186 | Kirsten Siler | Nurse Practitioner | 27a Medical Center Drive, Jackson, TN 38301-3949 | 2019-10-10 |
| 1801447693 | Milestone Primary Care House Calls, LLC | Nurse Practitioner | 5260 Cedar Park Dr Ste E, Jackson, MS 39206-4131 | 2019-09-24 |
| 1750855870 | Michael L Chesney | Nurse Practitioner | 6055 Jordan Rd, Jackson, MI 49201-9580 | 2019-01-12 |
| 1609356500 | Angela Sophia Mcreynolds | Nurse Practitioner | 2500 N State St Rm S347, Jackson, MS 39216-4500 | 2018-08-20 |
| 1679050132 | Alicia Faye Green | Nurse Practitioner | 908 Bella Vista Dr, Jackson, MO 63755-7863 | 2018-07-26 |
| 1982119228 | Felix Taylor | Nurse Practitioner | 514 E Woodrow Wilson Ave Ste B, Jackson, MS 39216-4538 | 2017-12-08 |
| Find all providers in JACKSON | ||||
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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.