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  7. NPI Record 1811542020

KEITH ANDREW MARTIN
Complete NPI Record 1811542020
Physical Therapy Assistant in Palm Beach Gardens, FL

NPI Status: Active since August 05, 2019

Contact Information

8551 WAKEFIELD DR
PALM BEACH GARDENS, FL
ZIP 33410
Phone: (561) 385-1043

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider First Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider First Line Business Practice Location Address
  12. Provider Business Practice Location Address City Name
  13. Provider Business Practice Location Address State Name
  14. Provider Business Practice Location Address Postal Code
  15. Provider Business Practice Location Address Country Code If outside U S
  16. Provider Business Practice Location Address Telephone Number
  17. Provider Enumeration Date
  18. Last Update Date
  19. Provider Gender Code
  20. Healthcare Provider Taxonomy Code 1
  21. Healthcare Provider Primary Taxonomy Switch 1
  22. Healthcare Provider Taxonomy Code 2
  23. Provider License Number 2
  24. Provider License Number State Code 2
  25. Healthcare Provider Primary Taxonomy Switch 2
  26. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1811542020. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1811542020
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Entity Type Code: 1
The country code in the location address of the provider being identified.
The telephone number associated with the location address of the provider being identified.
Provider First Name: KEITH
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Middle Name: ANDREW
The date that a record was last updated or changed.
Provider First Line Business Mailing Address: 8551 WAKEFIELD DR
The code designating the provider’s gender if the provider is a person.
Provider Business Mailing Address City Name: PALM BEACH GARDENS
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Mailing Address State Name: FL
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider Business Mailing Address Postal Code: 334106363
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Provider Business Mailing Address Country Code If outside U S : US
Provider First Line Business Practice Location Address: 8551 WAKEFIELD DR
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Provider Business Practice Location Address City Name: PALM BEACH GARDENS
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Provider Business Practice Location Address State Name: FL
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 334106363
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 5613851043
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 8/5/2019
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 8/5/2019
The date that a record was last updated or changed.
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 225200000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 225200000X
Provider License Number 2: PTA23997
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 2: FL
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 2: Y
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No