MS. CYNTHIA SHACKLETON MARTIN PA-C NPI 1821198839

NPI Information

NPI: 1821198839
Provider Name: MS. CYNTHIA SHACKLETON MARTIN, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Organization: ST VINCENT HOSPITAL-HOSPITAL SISTERS-THIRD ORDER OF ST FRANCIS

PECOS Registration: Yes

Address:
835 S VAN BUREN ST
GREEN BAY, WI
ZIP 54301
Phone: (920) 433-8384
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MS. Cynthia Shackleton Martin, PA-C is a medical physician assistant in Green Bay, WI with 23 years of experience. MS. Cynthia Shackleton Martin, PA-C NPI is 1821198839. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

835 S VAN BUREN ST
GREEN BAY, WI
ZIP 54301-526
Phone: (920) 433-8384

The NPI 1821198839 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 2/23/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	1359-023	WISCONSIN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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