RICKY LEE MARTIN JR. (NPI# 1174880447) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174880447 |
| Entity Type | Individual |
| Full Name | RICKY LEE MARTIN JR. |
| Credential | PA-C |
| Practice Address |
2326 18th St Ste 210 Columbus IN 47201-5362 |
| Mailing Address |
Po Box 775383 Chicago IL 60677-5383 |
| Practice Telephone | 8123728680 |
| Mailing Telephone | 8123753000 |
| Mailing Fax Number | 8123753477 |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2020-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
10002016A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4700 Las Vegas Blvd N, Nellis Afb, NV 891916600 | 7026533969 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124292024 | Ricky Anthony Martin | Counselor | 1281 Fleming Ave, San Jose, CA 95127-3610 | 2008-04-22 |
| 1821113622 | Ricky Ray Martin | Counselor | 601 Gregg Ave, Florence, SC 29502 | 2007-03-20 |
| Street Address |
2326 18TH ST STE 210 |
| City | COLUMBUS |
| State | IN |
| Zip Code | 47201-5362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528620325 | Brittany L Morehead | Nurse Practitioner | 2326 18th St Ste 210, Columbus, IN 47201-5362 | 2019-07-01 |
| 1184086795 | Carlie Johnson | Registered Nurse | 2326 18th St Ste 210, Columbus, IN 47201-5362 | 2016-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699389569 | Ryanne Nicole Slavens | Speech-Language Pathologist | 1974 Glenmoor Drive, Columbus, IN 47201 | 2020-09-08 |
| 1023670759 | Alisha Nicole Scoville | Counselor | 2630 22nd Street, Columbus, IN 47201 | 2019-07-02 |
| 1467964718 | Columbus Radiology Physicians LLC | Radiology | 2400 E. 17th Street, Columbus, IN 47201 | 2017-10-26 |
| 1790148849 | Gabriel Woon | Specialist | 913 25th St., Columbus, IN 47201 | 2016-04-05 |
| 1144680604 | Forefront Dermatology, S.c. | Dermatology | 244 Westwood Blvd, Columbus, IN 47201 | 2016-02-26 |
| 1871832550 | Jennifer Lynn Grant | Nurse Practitioner | 836 Jackson St., Columbus, IN 47201 | 2013-01-31 |
| 1235404526 | Eric Philip Tannenbaum | Orthopaedic Surgery | 940 N Marr Rd Ste C, Columbus, IN 47201 | 2012-03-20 |
| 1881994176 | Terri Ann Brewer | Social Worker | 12000 W. Moores Vineyard Rd, Columbus, IN 47201 | 2010-11-02 |
| 1255654620 | The Kane Group LLC | Durable Medical Equipment & Medical Supplies | 927 Fourth Street, Columbus, IN 47201 | 2010-03-12 |
| 1023243771 | Allison K Royer | Otolaryngology | 2326 18th Street, Suite 230, Columbus, IN 47201 | 2009-05-26 |
| Find all providers in zip 47201 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972960359 | Autumn Combs | Physician Assistant | 437 N Gould Rd Apt F, Columbus, OH 43209-1139 | 2016-01-15 |
| 1740665926 | Julianne Gonzalez | Physician Assistant | 350 Manchester Expy, Columbus, GA 31904-6435 | 2015-07-29 |
| 1629461165 | Michael Bryant | Physician Assistant | 911 Rudgate Rd, Columbus, GA 31904-2948 | 2015-03-09 |
| 1710068374 | April K Howell | Physician Assistant | 2008 Wynnton Rd, Columbus, GA 31906-2407 | 2006-10-18 |
| 1124035399 | Diane L. Mitchell | Physician Assistant | 1130 Talbotton Rd, Columbus, GA 31904-8749 | 2006-08-01 |
| 1194752790 | Karen L Goodale | Physician Assistant | 2881 Nc Hwy 108 E, Columbus, NC 28722-7721 | 2006-06-27 |
| 1164469979 | Mark H Epps | Physician Assistant | 2000 10th Ave Ste 270, Columbus, GA 31901-3706 | 2006-06-01 |
| 1164484689 | Jim Lawrence Mcevers | Physician Assistant | 109 Shult Dr, Suite 101, Columbus, TX 78934-3015 | 2006-04-03 |
| 1972586287 | Susan A Farwell | Physician Assistant | 45 E Mills St, Columbus, NC 28722 | 2005-11-22 |
| 1063402394 | Van Gregory Roberts | Physician Assistant | 8202 S Access Rd Bldg 946, Columbus, OH 43217-5903 | 2005-10-27 |
| Find all providers in COLUMBUS | ||||
Please comment or provide details below to improve the information on RICKY LEE MARTIN JR..
| 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.