MR. MARK RANDALL MARTIN (NPI# 1467563205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467563205 |
| Entity Type | Individual |
| Full Name | MR. MARK RANDALL MARTIN |
| Credential | L.C.P.C. |
| Practice Address |
1505 Eastland Dr Emp II Ll 1000 Bloomington IL 61701-3534 |
| Mailing Address |
45 Brookshire Grn Bloomington IL 61704-6211 |
| Practice Telephone | 3096631623 |
| Mailing Telephone | 3096638243 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
IL | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144763004 | Mark Martin | Technician, Other | 3041 S Charlton Park Rd, Hastings, MI 49058-8806 | 2016-11-28 |
| 1295707859 | Mark A Martin | Family Medicine | 2112 Pineshore Ct, Evansville, IN 47711-4473 | 2006-02-07 |
| 1578031860 | Mark Martin | Perfusionist | 6500 W Newberry Rd, Gainesville, FL 32605-4309 | 2018-11-05 |
| 1164916805 | Mark Martin | Counselor | 11811 Shaker Blvd Ste 123, Cleveland, OH 44120-1927 | 2018-06-17 |
| 1073023024 | Mark Martin | Social Worker | 1835 Gilmore Ave, Lakeland, FL 33805 | 2017-10-04 |
| 1952728347 | Mark Martin | Case Manager/Care Coordinator | 3612 Cuming St, Omaha, NE 68131-1952 | 2014-03-24 |
| 1447576103 | Mark J Martin | Nurse Practitioner | 286 Us Highway 23 N, Prestonsburg, KY 41653-8732 | 2010-04-20 |
| 1346490695 | Mark Martin | Counselor | 5673 Airport Rd, Roanoke, VA 24012-1119 | 2008-09-23 |
| 1982726436 | Mark Blair Martin | Dentist | 910 E Grand Ave, Escondido, CA 92025-3430 | 2007-04-04 |
| 1346300043 | Mark Kevin Martin | Recreation Therapist | 1975 Long Beach Blvd, Long Beach, CA 90806-5501 | 2006-12-11 |
| Street Address |
1505 EASTLAND DR EMP II LL 1000 |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-3534 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336142017 | Yogesh K Agarwal | Internal Medicine | 1505 Eastland Dr, Ste 330, Bloomington, IL 61701-3534 | 2005-05-24 |
| 1073082384 | Caroline J Turner | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2018-11-15 |
| 1548755366 | Sunanda R Kale | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2018-06-25 |
| 1790294403 | Sarah Kneip | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2017-09-26 |
| 1760909626 | Hannah K Corley | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2017-08-23 |
| 1467827592 | Kelly Karr | Registered Nurse | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2015-12-01 |
| 1205219607 | Michele Krieger-johnsen | Nurse Practitioner | 1505 Eastland Dr, Bloomington, IL 61701-7905 | 2015-07-02 |
| 1326420563 | Fresenius Medical Care Normal, LLC | Clinic/Center | 1505 Eastland Dr, Medical Plaza Lower Level, Bloomington, IL 61701-3534 | 2015-06-24 |
| 1588068803 | Allison Vogel | Physician Assistant | 1505 Eastland Dr, Bloomington, IL 61701-3534 | 2014-10-15 |
| 1578964987 | Kristin N Wilkins | Clinical Nurse Specialist | 1505 Eastland Dr, Suite 320, Bloomington, IL 61701-3534 | 2014-09-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265075162 | Angela Emily Brodine | Counselor | 5301 Hyland Greens Dr Apt 702, Bloomington, MN 55437-3909 | 2019-10-23 |
| 1184280141 | Holly Ann Wonders Myers | Counselor | 209 S Prospect Rd Ste 1, Bloomington, IL 61704-4697 | 2019-05-15 |
| 1326502246 | Jacqueline Clare Vermaat | Counselor | 418 N Main St Fl 1, Bloomington, IL 61701-3916 | 2019-01-24 |
| 1275006215 | Cameron Lee Small | Counselor | 9156 Vincent Ave S, Bloomington, MN 55431 | 2019-01-02 |
| 1891286191 | Jefferson Williams | Counselor | 211 N Veterans Pkwy Ste 1, Bloomington, IL 61704-3568 | 2018-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1437663275 | Counseling Resource Institute LLC | Counselor | 2422 E Washington St Ste 107, Bloomington, IL 61704-1611 | 2017-11-30 |
| 1629596812 | Mental Wellness Center Inc | Counselor | 202 N Prospect Rd Ste 207, Bloomington, IL 61704 | 2017-09-07 |
| 1457728206 | Faye Freeman-smith | Counselor | 2416 E Washington St Ste A2, Bloomington, IL 61704-1608 | 2015-08-27 |
| 1902289994 | John Leslie Freshour | Counselor | 616 Iaa Dr, Bloomington, IL 61701-2225 | 2015-07-08 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
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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.